Vol 15 (2026): Материалы XXII Международного Бурденковского научного Конгресса, 23–25 апреля 2026 года, г. Воронеж

Normal human anatomy and other morphological disciplines are the foundation of knowledge necessary throughout their studies for students of medical universities. Studying these disciplines is a difficult stage of the learning process. The visibility of the subjects under consideration is part of the academic support base and methodological framework. Topographic and anatomical preparations actually enable us to understand the integrality of the human body and the relative location of anatomical structures.Classical anatomical dissection allows you to create visual materials for studying morphological disciplines. In the course of our work, we resorted to modifying classical techniques in order to create more detailed preparations. In addition to classical dissection, the method of creating topographic and anatomical cuts of the lower limb was used in modification of the classical “ice anatomy” by N.I. Pirogov.We have set the task to modify the classical theoretical conceptual algorithm for working with biological material. The result of this approach was the creation of high-quality and informative topographic and anatomical preparations.For dissection, we used biological material presented by amputated lower limbs.  Specially selected surgical instruments were used during the work.In this paper, we present a modification of classical dissection techniques, based on the variation in the ratio of structures within the dissected area.According to the proposed methods, a number of anatomical preparations were made, which are materials for studying normal and topographic human anatomy, as well as objects of the anatomical museum.

In modern conditions of a significant shortage of biological material in medical universities, the development of new methods for creating visual anatomical preparations that are durable and highly informative for the educational process is becoming particularly relevant. The widespread use of laboratory animals compensates for the lack of anatomical material, allowing students to improve their understanding of comparative anatomy, make correlations with the topography of the human body, and master dissection skills. Vascular preparations and organ complexes occupy a special place among the textbooks. In this regard, there is a need to create drugs that meet modern educational needs. This paper presents innovative variations of corrosion casting that expand the classical technique and give new functional properties to the preparations. The first modification is based on the introduction of a phosphor into the polymer mixture, which provides a bright, uniform glow of the preparations in the ultraviolet spectrum. This makes it possible to enhance the contrast of the vascular pattern and create highly visual teaching aids for demonstration in darkened classrooms. The second modification consists in adding a radiopaque substance to the filling mixture, which provides visualization of the obtained casts using computed tomography methods. This approach opens up opportunities for digital three-dimensional modeling and preservation of unique samples in virtual form without the risk of damaging the originals. The third modification is the production of full-size preparations of vascular networks of laboratory animals, which demonstrate the systemic architecture of the vascular network from the main arteries to capillary structures, forming a clear picture of the circulatory system as a single functional network. The developed techniques represent a practical solution for creating high-quality anatomical manuals that complement the collections of morphological museums and contribute to increasing the level of understanding, study and comparative analysis of vascular architectonics.

In medical universities, the demonstration of material using anatomical specimens is crucial. This method allows students to study the morphology and topography of the body's structures in detail. For the proper use of educational specimens, their preservation and microbiological safety are important, which is ensured by chemical treatment, placement in a preservative medium, and in some cases, embalming of biomaterial. Currently, various formalin solutions are used as the main preservative, as they are highly effective and inexpensive. However, according to modern scientific data, the use of formalin as a fixative does not guarantee the complete destruction of microflora. Bacteria, fungi, and viruses remain on the surface of specimens and in preservative liquids. This can lead to potential infection of students and staff if they are not careful. In addition, the presence of microorganisms can affect the preservation of anatomical specimens. There have been well-known cases in history of morphological preservation of bodies being compromised by mold fungi, for example, the bodies of N.I. Pirogov and V.I. Lenin. Thus, the aim of this work is to study the diversity of microorganisms found on educational anatomical specimens, assess potential infectious risks and the impact of microflora on the preservation of materials. The study includes a review of scientific literature and microbiological analysis of samples from the museums of the Department of Normal Anatomy at Petrovsky Medical University and the A.P. Avtsyn Research Institute of Human Morphology, named after Academician B.V. Petrovsky. The results of the work allow microorganisms in the studied environments to be classified and the composition of preservative solutions for the protection of educational and museum anatomical specimens to be improved.

One of the urgent problems today is the problem of childhood injuries. According to the latest data, fractures account for 24.5%. Fractures in childhood can cause various complications: deformity or shortening of limbs, as well as arthritis and avascular necrosis of bones.
Childhood fractures need to be treated differently from adult fractures. To improve the understanding of medical students about the specifics of childhood fractures, we have developed a method for visualizing them by making models that demonstrate the structure of the fracture.
When making the models, we used bone models, epoxy resin, and spokes for intramedular osteosynthesis.
The conducted analytical study helped to obtain statistical data on childhood injuries in the Moscow Regional Children's Clinical Trauma and Orthopedic Hospital, and also showed the relevance of this problem, which allowed us to continue developing visual aids for medical students in order to deepen the study of traumatological aspects of anatomy.
Keywords: anatomy; traumatology; anatomical models; X-ray anatomy

Compulsive overeating is defined as an irresistible, intense internal urge to consume large amounts of food, regardless of the signals of hunger and satiety. The pathophysiology of compulsive overeating and food addiction is a complex interweaving of functional disorders of neurochemical systems, primarily the mesocorticolimbic dopamine pathway. Chronic consumption of highly unattractive foods rich in fats and refined carbohydrates leads not to an increase, but to a decrease in dopaminergic transmission, which is manifested by the formation of a state of reward deficiency. In recent years, the microRNA system has been considered as a regulator of these neurohumoral rearrangements. The aim of this work was to study changes in the expression levels of miR-29c-3p and miR-let-7b-5p in the prefrontal cortex of female rats in a model of compulsive overeating. The microRNA expression level was assessed by real-time PCR. As a result, a statistically significant multidirectional change in expression was revealed.: increase miR-let-7b-5p and decrease miR-29c-3p. The data obtained indicate a differentiated involvement of the studied microRNAs in the regulation of neuroplasticity in compulsive overeating: an increase in miR-let-7b-5p may reflect the activation of synaptic plasticity mechanisms characteristic of dependent conditions, while a decrease in miR-29c-3p is consistent with its supposed protective role in the development of food addiction.

The article analyzes the importance of biochemical parameters as objective criteria for assessing the degree of fatigue and diagnosing pre-pathological changes in individuals exposed to intense physical exertion. The parameters of carbohydrate and protein metabolism, enzymatic activity and hormonal background are considered. It is proved that systematic monitoring of such indicators as creatine phosphokinase, lactate, as well as the ratio of testosterone and cortisol, provides an opportunity not only to detect the presence of overtraining, but also to anticipate its occurrence. This approach facilitates the transition from delayed correction to proactive management of the training process.

The article presents the results of long-term monitoring of the quality and safety of food products enriched with vitamin-mineral complexes sold on the consumer market of the Voronezh Region within the framework of the national project "Demography" for the period 2020-2024. The studies were conducted by the testing laboratory center of the FBHI "Center for Hygiene and Epidemiology in the Voronezh Region" using modern analytical methods, including gas and high-performance liquid chromatography, and atomic absorption spectrometry. It was established that enrichment is most widely used in the production of dairy products and grain products (breakfast cereals, crispbreads). A positive trend was revealed in the reduction of the proportion of substandard products from 33.7% in 2020 to 7.25% in 2024. The main types of violations were reduced content or absence of declared vitamins (D, B group, PP) and minerals (calcium, iron, iodine, zinc), as well as non-compliance of the fatty acid composition of dairy products, indicating adulteration. The obtained data indicate the need for constant laboratory control over the reliability of labeling of enriched products and compliance with technological regulations when using vitamin-mineral premixes.

Introduction. Rational nutrition is not only the most important aspect of a healthy lifestyle, but also the basis for the prevention of alimentary-dependent conditions. The principles of healthy eating are enshrined in a number of national projects. The federal project "Health for Everyone" is being implemented in the Russian Federation, within the framework of which this study was conducted. The purpose of the work is to evaluate the results of the survey and analyze the diet and nutritional status of students. Materials and methods. The study was conducted on the basis of the Center for Hygiene and Epidemiology in the Voronezh Region. The survey was conducted among 348 respondents aged 18-21 years. Results. Data analysis revealed significant dietary violations: more than 40% of higher education students do not observe the frequency of meals on school days. An imbalance in the diet was noted, manifested in a lack of consumption of fish, dairy products and fruits with an excess of cereals. The regional indicator of overweight is 19% higher among university students than the national average, as well as a high prevalence of bad habits, including alcohol consumption (55% among university students). Conclusion. The data obtained confirm the need for sanitary and educational work among students. The collection and analysis of data on actual nutrition conducted by the sanitary and epidemiological surveillance authorities serves as the basis for the development of preventive programs and recommendations that contribute to the preservation and promotion of youth health.

A review of the factors influencing the development of acute respiratory viral infections in the Voronezh Region in the period December 2025 — January 2026 was conducted. Acute respiratory viral infections are the most common diseases among the population of all countries and have various forms of course. Viral diseases are also widespread in the Voronezh Region. Environmental factors have a significant impact on the course of acute respiratory viral infections, so the goal was to identify the most common ones. After analyzing the cases of infection at the VOKIB Medical Center, it was possible to identify the most common groups of environmental conditions, such as low temperatures, sick relatives, closed organized groups, and lack of vaccination against seasonal viral infections. Hypothermia is a key factor that undermines the immune system. Infections also find fertile ground for spreading in closed communities and the family circle. People aged 18-35 and over 55 are the most susceptible to diseases, which indicates a direct relationship between the level of social activity, family ties and the rate of infection spread. The data obtained will help improve prevention, including vaccination and informing residents about the risks of close contact during the cold season.

The relevance of this work is due to the widespread use of smartphones and the emergence of informal reports of discomfort in the little finger arising from the typical grip of the device. The aim of the study was to assess the prevalence of complaints of pain, numbness, and deformation in the little finger area among smartphone users, and to identify the association with device characteristics and usage patterns. A cross-sectional survey of 51 respondents (88.2% women, 11.8% men; mean age 22.4±8.1 years, predominantly students - 82.4%) was conducted. Data were collected on smartphone parameters (screen size, weight), daily duration of use, presence and nature of discomfort (location, type of sensation, time of onset), and typical grip. Statistical processing included frequency calculation, comparative, and correlation analysis. Results: complaints of discomfort in the little finger at least occasionally were reported by 62.7% of respondents (regularly - 19.6%, occasionally - 43.1%). Among these, the most frequent localization was pain in the joint at the base of the little finger (59.4%), an indentation/flattening on the side (40.6%), pain in the middle or upper phalanx (31.3%), and discomfort in the entire palm (25.0%). The nature of sensations: numbness (62.5%), aching pain (53.1%), sharp stabbing pain (12.5%). In 71.9% of respondents with complaints, unpleasant symptoms appeared after 1–2 hours of continuous use or more. A direct correlation was found between daily usage time (more than 4 hours) and the presence of discomfort (r=0.41; p<0.01). Users of heavy smartphones (weight over 200 g) and large screen sizes (≥6.3 inches) more often reported little finger deformation (p<0.05). The most common grip - one-handed with the lower corner of the device resting on the little finger (reported by 68.6% of all participants) - was associated with a higher frequency of complaints (χ²=6.2; p=0.04). The "smartphone pinky" phenomenon is confirmed as a significant problem: almost two-thirds of users experience discomfort associated with prolonged use and device ergonomics. The obtained data substantiate the need to develop recommendations for safe grip, use of accessories, and smartphone operation regimens for the prevention of repetitive strain injuries of the hand.

Ensuring the safety of the air environment in medical organizations for immunocompromised patients is a critical factor in the prevention of infections associated with medical care. The paper presents an analysis of the complex of measures for air disinfection in the Voronezh Regional Clinical Center for the Prevention and Control of AIDS (VOKTSPIBS), operating in reconstructed buildings with an atypical layout for an infectious diseases hospital. An assessment of the compliance of ventilation systems and equipment with the requirements of SanPiN 3.3686-21 was carried out, the nomenclature and operating modes of air disinfection plants were studied: closed-type bactericidal irradiators, pulsed UV installation WICb-01-Alpha, aerosol generators, microbiological safety boxes. It has been established that if it is impossible to install HEPA filters in the supply and exhaust ventilation, epidemiological safety is achieved by a combination of physical and chemical methods. It is shown that the use of recirculators in the presence of people, pulse installations for rapid decontamination and aerosol disinfection makes it possible to compensate for architectural shortcomings (a common corridor, lack of vestibule locks). During the period of conversion to COVID-19 (2020-2022), organizational solutions combined with an enhanced disinfection regime made it possible to avoid nosocomial infection. In laboratory units, Class II microbiological safety boxes with annual monitoring of HEPA filters are a key safety element. It is concluded that an integrated approach combining physical and chemical technologies of air disinfection with strict industrial control ensures the epidemiological safety of the air environment in a specialized center, even with atypical architectural solutions.

Currently, pertussis infection has again become particularly relevant in almost all countries of the world, despite the availability of effective drugs for immunization. A key role in the formation of immunity against pertussis infection is played by the timeliness of vaccination, the level of vaccination and vaccination coverage of children. In recent years, incidence rates have continued to rise, despite the high coverage of whooping cough vaccinations among children in the Voronezh region. Target. Conduct an analysis of the level of immunization among the child population of the Voronezh region for the period 2022 - 2024. Materials and methods. The research material was Rosstat reporting forms No. 2, No. 5 and No. 6, data on the population, monthly orders for medical immunobiological drugs supplied at the expense of the federal and regional budgets for the implementation of the National Calendar of Preventive Vaccinations. Results. In the first year of life, no more than 49% of children are vaccinated on time, with an expected 95% coverage. In addition, revaccination continues in some cases even in the fourth year of life, despite the age stipulated by the National Preventive Vaccination Calendar of 18 months. Conclusions. The data obtained indicate an insufficient level of vaccination coverage and shifts in whooping cough immunization schemes in the Voronezh region, which undoubtedly affects the worsening of the epidemic situation.

The assessment of nutritional composition is being replaced by an understanding of the significance of industrial food processing as an independent health risk factor. While the international scientific community actively uses the NOVA and SIGA classifications, the Russian consumer information system ("Traffic Light" labelling, GOST standards) remains focused on traditional indicators of product safety and quality.Objective. To conduct a comparative analysis of food classifications based on processing degree (NOVA, SIGA) and existing Russian approaches ("Traffic Light" labelling, GOST compliance) to assess their comparability and applicability in the Russian dairy market.Methods. A cross-sectional study of 100 samples of fermented milk products purchased from retail chains in the city of Voronezh was conducted. For each sample, the ingredient composition, nutritional value, presence of "Traffic Light" labelling, and GOST compliance were analyzed. The products were classified according to the NOVA system (groups 1–4) and the SIGA algorithm, which involves counting ultra-processing markers (UPM) and assessing nutritional thresholds.Results. The proportion of ultra-processed products (NOVA group 4) in the sample was 42%. The SIGA system allowed for further detailing of this group: 28% of samples were classified as category C1 (high level of processing), and 14% as C0 (borderline). Based on the analysis of information found on consumer packaging (including products not subject to sampling), significant discrepancies with the "Traffic Light" labelling were revealed: 31% of products with "green" or "yellow" indicators for fat and sugar content contained two or more ultra-processing markers according to SIGA criteria and were classified as ultra-processed. Compliance with GOST did not guarantee the absence of UPM: 15% of products labelled as "GOST" contained one or more markers due to permitted technological additives.Conclusions. The current Russian "Traffic Light" labelling system and consumer reliance on GOST standards do not allow for the full identification of ultra-processed products. The SIGA system provides the most differentiated assessment. The findings substantiate the need for implementing a hybrid approach that considers both international criteria and national standards to improve the consumer information system in Russia.

Introduction. The health status of students of medical universities is an important medical and social problem, since training is accompanied by a high academic load, psycho-emotional stress, a violation of the daily routine and diet, which may contribute to the development of functional disorders of the gastrointestinal tract. Target. A study of the relationship between academic stress and the frequency and nature of gastroenterological complaints in medical university students. Materials and methods. 199 students of 2 courses of medical and pediatric faculties of VGMU took part in the research. N. N. Burdenko. The collection of data was carried out by the questionnaire method, which included questions about the dietary regime, study stress factors and the presence of gastroenterological complaints. Statistical data processing was carried out using methods of descriptive statistics. The results. It was established that gastroenterological complaints were noted in 61.3% of students. The most common symptoms were nausea, loss of appetite and a feeling of heaviness in life. A significant part of the respondents noted an increase in symptoms during periods of increased academic load, which indicates the possible influence of academic stress and eating disorders. Conclusion. The obtained data indicate the prevalence of functional disorders of the digestive system among medical university students and confirm the need to develop preventive measures aimed at reducing the level of academic stress and optimizing the diet and rest regime.

Various factors affect the health of students as well as academic performance: high academic load, lack of motivation, inability to effectively organize their time. In a medical school, these difficulties combine, creating an exceptional stressful environment for learning. The most critical problem for future doctors is the violation of the basic principles of a healthy lifestyle. An irrational daily routine, lack of sleep and unbalanced nutrition directly reduce the cognitive functions of students: memory, attention, the ability to assimilate material. Purpose. Assessing the impact of key lifestyle factors on medical student academic performance. Materials and methods. A survey of 102 second-year students was conducted, their subjective assessments of the educational process and lifestyle were analyzed. Results. In the course of the work, it turned out that more than half of the students sleep less than 6 hours a day, and the vast majority consider their meals irrational. At the same time, the key factors that impede successful study are lack of sleep, irrational nutrition, a large amount of material, inability to plan time and bad habits. Conclusion. The most significant correlation is shown between lack of sleep and academic performance (r = 0.68). To increase academic performance, it is necessary to introduce into the educational process programs aimed at the formation of practical health and time management skills.

The article presents the results of a 12-week randomized controlled trial evaluating the effectiveness of mobile applications for nutrition monitoring (MyFitnessPal, FatSecret, Yazio) as a tool for forming healthy habits in university students. The study involved 121 students (91 women, 30 men), mean age 20.4±2.1 years. The experimental group consisted of 63 students who agreed to use nutrition monitoring apps for 12 weeks (MyFitnessPal – 52%, FatSecret – 28%, Yazio – 20%). The control group (58 individuals) did not use the apps. The groups were comparable in gender, age, and baseline BMI (p>0.05). Main results. The experimental group showed a statistically significant improvement in healthy eating scale scores: the mean score increased from 12.4±3.2 to 16.8±3.9 (p<0.001), while no changes were observed in the control group (12.6±3.1 vs 12.8±3.4; p=0.62). Fruit and vegetable consumption in the experimental group increased by 42% (p<0.01), fast food consumption decreased by 37% (p<0.01), and the proportion of students eating breakfast daily rose from 41% to 67% (p=0.003). BMI in the experimental group decreased by an average of 0.8 kg/m² (from 23.5±3.1 to 22.7±2.9; p=0.02), mainly due to participants with initial overweight. Subjective health self-assessment (SF-12 scale) increased from 68.3±11.2 to 74.1±10.5 points (p=0.008), and stress levels decreased from 6.2±1.8 to 5.1±1.9 points on a 10-point scale (p=0.01). A direct correlation was found between the intensity of app use and the degree of improvement (r=0.62; p<0.001): participants who logged data daily improved their nutrition score by 5.8±1.9, while those logging less than 3 times a week improved by only 2.1±1.4 (p<0.001). The main barriers to use were: lack of discipline/regularity in data entry (54%), distrust of the accuracy of calorie counting in apps (32%), and interface complexity (18%). At the same time, 76% of users noted that the apps increased their awareness of food composition and actual portion sizes.

According to studies conducted in 2020-2025, the intestinal microbiota plays a role in the development of various cardiovascular diseases. The intestinal microbiota functions as an endocrine organ. It has been proven that an imbalance in the taxonomic composition of the microbiota leads to various metabolic disorders in lipid and carbohydrate metabolism. The purpose of this study is to summarize the current literature on the role of intestinal bacteria in the progression of atherosclerosis and thrombosis, as well as to describe the mechanisms underlying the pathogenesis of these diseases. Materials and methods. We have analyzed domestic and foreign articles, abstracts of candidate and doctoral dissertations on the research topic. Results. In the course of literature analysis, we have identified several key functions of intestinal bacteria that contribute to the development of atherosclerosis and thrombosis: synthesis of secondary bile acids, regulation of the synthesis of secondary bile acids by negative feedback, synthesis of TMA (trimethylamine), PAG (phenylacetylglutamine), TMAO (trimethylaminoxide). A provoking factor for the synthesis of TMAO and TMA is a high consumption of dairy products and red meat (they contain such compounds as lecithin, choline, L-carnitine – TMA precursors). TMAO changes the concentration of Ca2+ ions inside platelets, triggers the activation of integrin glycoprotein IIb/IIIa, which in turn accelerates the processes of platelet adhesion. Conclusion. Atherosclerosis and thrombosis are inextricably linked to the gut microbiota. Intestinal dysbiosis leads to the progression of these pathologies.

Waldenström's macroglobulinemia (WM) is a rare lymphoproliferative disorder that can be complicated by kidney damage with the development of paraproteinemic nephropathy and systemic disorders, including cardiorenal syndrome. The difficulty of timely diagnosis is due to the polymorphism of the clinical picture. Objective. To present a clinical case of WM associated with severe kidney damage and the development of cardiorenal syndrome. Methods. An analysis of the medical history, laboratory and instrumental data of a 71-year-old patient with a verified diagnosis of Waldenström's macroglobulinemia was carried out. Results. The patient exhibited progressive proteinuria (up to 9.5 g/L), an increase in creatinine (up to 259.6 µmol/L), hypoalbuminemia (up to 27.1 g/L), as well as cardiac dysfunction with a left ventricular ejection fraction of 46% and bilateral hydrothorax. The diagnosis of WM was confirmed by immunophenotyping and immunohistochemistry of the bone marrow. Conclusion. This case demonstrates the need for interdisciplinary interaction for the early diagnosis of paraproteinemic nephropathies and the correction of life-threatening complications in patients with WM.

The era of widespread digitalization has created a paradoxical situation: technologies designed to improve the quality and accessibility of medical care have simultaneously created a critical vulnerability to cyberterrorist attacks. Cyberterrorism today is no longer a hypothetical threat, but a real tool for destabilizing society, aimed at causing harm, disrupting infrastructure, and achieving political goals. Attacks on medical information systems create extreme working conditions for medical personnel. Under these circumstances, medical workers find themselves on the front lines not only in the fight for patients' lives but also as direct participants in new types of emergencies. The relevance of this work is driven by the exponential growth in the number of cyber incidents in the medical field, as well as the high probability of medical errors due to acute stress, which requires the development of specific protective measures not only for technological protection but also for the psychological well-being of medical personnel. This paper systematizes current data on cyberterrorism, analyzes the impact of misinformation and healthcare system disruptions on clinical decision-making, and examines potential methods for developing psychological and professional resilience, as well as behavioral algorithms for healthcare workers to minimize the consequences of cyberattacks in the hospital setting. Objective. To analyze the impact of cyberattacks on healthcare and clinical decision-making, and to substantiate the psychological resilience of physicians as an element of anti-terrorism defense. Materials and Methods. A systematic analysis of scientific publications, WHO and Interpol reports, and documented cases of cyber incidents in healthcare facilities. Results. Digitalization has created critical vulnerabilities for cyberterrorism. Disorganization of healthcare systems leads to extreme working conditions, increased cognitive load, and medical errors. Healthcare workers find themselves on the front lines of a new type of emergency. Conclusion. The rise in cyberattacks requires comprehensive protection, including technological measures and personnel training. Behavioral algorithms and professional resilience programs for physicians are needed to minimize the consequences and save patients' lives.

Introduction. The article presents the results of a study devoted to the assessment of the level of theoretical knowledge, practical skills of schoolchildren in the field of first aid.

The goal is to identify existing gaps in the training system and analyze the factors affecting the effectiveness of skills acquisition within the curriculum of the basics of life safety course.

Materials and methods: the study was carried out by means of a specially developed anonymous questionnaire with the subsequent processing of the data obtained. An analysis of the current federal state educational standards and curricula in the discipline "Fundamentals of Life Safety" was also carried out.

Results of the study: the study showed that there is an insufficient level of knowledge and training in first aid among schoolchildren, especially in terms of practical application of knowledge.

Conclusions. The conclusion concludes that a systematic and practical approach to training will overcome the existing gap between theory and real readiness to act. Based on the data obtained, measures are proposed to optimize curricula and methods, including the introduction of practice-oriented first aid courses, equipping educational institutions with special equipment, and the active use of interactive formats.

Road traffic accidents remain one of the leading causes of death and disability of the population. Existing educational programs for future doctors are often focused solely on physiological life-saving (algorithms for stopping bleeding, anti-shock measures), ignoring the psychological component. Modern disaster medicine is increasingly focusing on the need to integrate psychological support into the algorithms of ambulance crews and eyewitnesses with medical education. Purpose: to assess students' awareness of emergency psychological support in case of an accident. Methods: a student survey is organized. Results: the results of the survey confirmed the presence of fear and uncertainty among students when it is necessary to provide such assistance, as well as a lack of knowledge about the correct ways of verbal communication with victims. Conclusions: This justifies the expediency of introducing additional courses into the educational process to enhance the competence of future doctors in the field of psychological support for victims of road accidents.

The relevance of the study is due to the high significance of the problem of socio-psychological readaptation of specialists involved in the elimination of the consequences of emergencies and counter-terrorism operations, since the impact of psychotraumatic factors determines the formation of stable maladaptive patterns in the post-extreme period. The aim of this study was to identify early signs of post-traumatic stress disorder in individuals exposed to adverse psychotraumatic factors of an emergency situation. The study involved 31 participants in counter-terrorism operations, with an average age of 35 and an average length of service of 3 years. The psychodiagnostic tools included an author's questionnaire aimed at identifying complaints, characteristics of well-being and reactions, as well as I.O. Kotenev's OTS questionnaire for screening for symptoms of post-traumatic stress disorder. The study found that 67.7% of respondents had experienced a traumatic situation accompanied by feelings of fear and helplessness, with regular contact with family members having a positive effect on only 45.2% of respondents, while in the remaining cases, support was provided by a medical psychologist. The vast majority of participants (83.9%) consider it necessary to provide continuous qualified psychological assistance directly in the emergency zone. According to the OTS questionnaire, 67.7% of respondents showed isolated, mild symptoms (50–65 TB), 22.6% were diagnosed with partial symptoms of PTSD or acute stress disorder (65–75 TB), and 9.7% had clinically significant symptoms (≥75 TB), with no respondents reporting no symptoms. The results obtained indicate the total nature of the psychological trauma of the surveyed contingent and the need for systematic psychological support at all stages of professional activity, while the identified lack of family support highlights the role of the medical psychologist as a key resource for maintaining the mental health of specialists in extreme professions.

Introduction. In practice, at the time of first aid for critical bleeding, there is a problem of choosing a specific harness model from the many available today. There is a wide range of harnesses of various designs on the market, which sets the task of specialists with a comparative analysis of their effectiveness for a reasonable choice and equipment.The purpose of the study is to assess the effectiveness and functional characteristics of various types of hemostatic tourniquets by a number of key parameters, in order to select and apply them, as well as the ability to use the studied bundles among students of a medical educational institution and students of other non-specialized higher educational institutions.Materials and methods. In this work, a one-time comparative study was conducted with the participation of 30 students, 5 types of bundles were evaluated: Esmarch, mechanical turnstile of CAT-type, RATS-type harness, venous harness and "Alpha" harness, the time of application, the rate of successful bleeding stop was measured and technical errors were recorded.Research results. The participants used the turnstile most quickly and effectively. Esmarch and RATS-type harness showed average results, and the venous harness and Alpha harness were ineffective.Conclusions. The study confirmed that mechanical turnstiles are the most effective and fast-to-use tool that deserves the status of a "gold standard".

Children who depend on respiratory support (invasive ventilator and noninvasive CPAP therapy) represent the most vulnerable category of patients in emergency situations. Their life support critically depends on uninterrupted power supply, the availability of supplies and qualified personnel. GOST R 22.3.02-2025 formalized a two-stage system of medical evacuation support [1], however, the special needs of children with respiratory dependence were not regulated in detail in the document. Goal. To substantiate the need for a differentiated approach to the organization of evacuation of children undergoing various types of respiratory support in emergency situations. Materials and methods. Based on the analysis of domestic and international sources, including studies of the effects of earthquakes in Japan (1995, 2011), the experience of sanitary aviation in the Lipetsk and Voronezh regions [3, 4, 9, 10], local documents of medical organizations [5, 6], as well as fundamental textbooks [7], the authors identify a systemic gap: patients on noninvasive CPAP therapy are not considered by disaster medicine services when planning evacuation measures. Results. In a real emergency situation (fire, power outage, collapse, massive influx of victims) this leads to a fatal delay in evacuation, incompatibility of equipment and lack of trained personnel. The article substantiates the need for a differentiated approach to planning the evacuation of children to mechanical ventilation and CPAP (Continuous Positive Airway Pressure), and suggests organizational solutions ranging from the creation of regional registries and "power safe" maps to standardized checklists for aviation medical teams and regulations for interdepartmental interaction. Conclusion. It is necessary to introduce regional registries, "power safe" cards and checklists for aviation medical teams.

The article analyzes the role of import substitution and its impact on medical personnel. Due to the imposed sanctions, the issue of providing the domestic healthcare system with medicines and equipment has become a priority. Import substitution has become the main approach to address this issue, as it has a significant impact on medical personnel.Target. To analyze how import substitution affects medical personnel

Methods.The analysis is based on a survey conducted among doctors and the results of a meeting of research groups.
Results.The survey revealed a complex and ambiguous situation regarding the implementation of domestic medical equipment in healthcare facilities.

Conclusions.On the one hand, the medical community is generally ready to use it and sees advantages such as affordable prices and simplified logistics for spare parts. On the other hand, there are several challenges such as lack of trust, inadequate training, limited information about the equipment, and underdeveloped service infrastructure.

Introduction. Blood loss from injuries and surgical interventions remains the leading cause of preventable mortality, especially in military conflicts and mass injuries. Local hemostatic agents are being actively introduced into practice both internationally and in Russia. Their advantage lies in their directional action, which makes it possible to effectively stop both massive and diffuse bleeding. Against the background of the development of tactical medicine, there is an increasing interest in local hemostatic agents that can quickly form a stable thrombus directly in the area of damage to the vascular wall. The purpose of this review is to summarize data on the classification, mechanisms of action, and clinical efficacy of modern topical hemostatics, including materials used in military first—aid kits. Materials and methods: domestic and foreign publications on collagen, cellulose, gelatin, chitosan-containing and kaolin compositions, as well as comparative studies in experiment and clinical practice, are analyzed. Results: special attention is paid to the use of hemostatic bandages at the prehospital stage for combat wounds, the effect of drugs on the survival of the wounded, the frequency of complications, the need for blood transfusions, and the duration of surgical interventions. Conclusions: practical conclusions are formulated to justify the rational choice of local hemostatic compositions for hospital and field conditions. 

The increasing frequency of emergencies and their multicomponent nature require improved information and analytical support for medical decisions. Artificial intelligence-based decision support systems (AI-DSS) have the potential to improve the accuracy of diagnosis, forecasting, and optimizing resource allocation, but their implementation in disaster medicine remains limited. Goal. To assess the current state, identify key areas and barriers to integrating AI-DSS into disaster medicine, and identify the conditions for their effective use. Methods. A systematic review of the scientific literature of 2023-2025, indexed in international databases and domestic sources, has been carried out. The methods of content analysis, systematization and conceptual synthesis are applied. Results. Three main areas of application of AI-DSS are identified: predictive systems for early detection of critical conditions, diagnostic solutions using computer vision, and logistical and tactical decision support systems. It has been shown that AI is capable of improving forecasting accuracy, speeding up diagnostics, and optimizing resource usage. The main barriers remain limited clinical validation, data variability, regulatory constraints, and problems integrating into existing infrastructure. Conclusions. The integration of AI-DSS into disaster medicine represents a promising avenue aimed at enhancing the efficiency of diagnostic, therapeutic, and organizational procedures. The analysis confirms the established potential of the technologies under consideration. However, their practical implementation is constrained by a set of methodological, regulatory, and infrastructural limitations, necessitating further research focused on clinical validation and the adaptation of these developments to the specific conditions of emergency situations.

This research paper is devoted to an urgent problem of the professional health of EMERCOM employees - the study of the mechanisms of occurrence and the specifics of the course of acute stress disorders (OCD) in personnel involved in the elimination of the consequences of emergencies associated with the death of children. Goal. Theoretical justification, as well as using the empirical part of the study, to identify the features of the emergency response among the staff of the Ministry of Emergency Situations when dealing with emergencies involving child victims, in order to develop recommendations for prevention. Materials and methods. The theoretical and methodological basis of the work was based on scientific publications by Russian and foreign authors in the field of psychology of extreme situations, psychiatry, and psychophysiology. The analysis of information contained in articles, systematic reviews, and methodological recommendations on the problems of professional stress in extreme specialists was carried out. The empirical part of the study included the development of a questionnaire for employees of the Ministry of Emergency Situations who participated in the elimination of emergencies with children. For this purpose, clinical questionnaires and standardized psychodiagnostic techniques were used (works by I.O. Kotenev, N.E. Vodopyanova, as well as diagnostic criteria of DSM-IV and ICD-10). Results. The study details specific stress factors (self-identification with a child, feeling powerless in the face of tragedy and an unfulfilled duty to protect). The survey results also revealed that employees who have participated in emergencies involving children have a higher risk of developing OCD. This indicates that they are more likely to develop a chronic form of post-traumatic stress disorder (PTSD). This is evidenced by their high scores on the intrusion, avoidance, and physiological arousal scales. Preventive measures should include psychological training for working with vulnerable populations, including children. An important aspect is the training of self-regulation skills and maintaining a psychoemotional and psychophysiological state of health. It is recommended to observe a work and rest regime, proper nutrition, and mutual assistance in the team. Conclusions. The goal was achieved: the features of acute stress disorders in employees of the Ministry of Emergency Situations during the elimination of emergencies with child victims were studied, and preventive measures were proposed. 

Introduction. The scientific article is devoted to the problem of providing psychological support to victims of emergency situations (emergencies) and rescuers involved in the elimination of the consequences of disasters. The purpose of the study is to conduct a comparative analysis of approaches to the provision of psychological assistance in different countries, to study the psychological consequences of disasters, to justify the effectiveness of the three-level model of psychological assistance, to determine the organizational and ethical principles of the work of psychological services in different countries, to develop recommendations for improving the studied system. Research materials and methods: the work uses methods of systematization and generalization of information to build a universal three-level model of assistance. The relevant documents of the United Nations and the International Federation of Red Cross and Red Crescent Societies are taken as a basis. The authors consider acute stress reactions, post-traumatic stress disorder (PTSD), professional burnout and secondary traumatization. Research results. The features of stress reactions and psychological consequences of disasters are highlighted, a comparative analysis of various models of the psychological support system is carried out. Conclusions. Comparative analysis shows that there is no universal model of psychological assistance. All three models studied in the scientific work show their effectiveness in socio-political contexts. 

The relevance of neuroinfections stems from their high disability and mortality rates, which depend on diagnostic accuracy and treatment timing.Aim: To assess clinical and laboratory features of purulent and serous nervous system lesions.Methods: A retrospective analysis of 95 pediatric cases (2024–2025) was performed. Group 1 included 9 children with purulent CNS lesions; Group 2 included 86 with serous lesions. All underwent clinical exams, blood biochemistry, and lumbar puncture.Results: Meningococcal infection accounted for 66.7% of purulent cases, predominantly in early childhood. Among specified viral etiologies, enterovirus (27.9%) was most common, followed by cytomegalovirus (4.7%) and HHV6 (1.2%), primarily in schoolchildren (58.3%). Mean pleocytosis in purulent meningitis was 4400.96 ± 780.1 × 10⁶/L, versus 195.42 ± 32.87 × 10⁶/L in serous cases. In 20% of viral meningitis, CSF neutrophil percentage reached 98% with normal lactate, whereas lactate was elevated in purulent meningitis.Conclusion: Enterovirus is the leading viral neuroinfection, peaking in schoolchildren during autumn-summer; meningococcus predominates in purulent cases, peaking in young children during winter-autumn. Neutrophilic pleocytosis occurs in 20% of viral meningitis, necessitating CSF lactate measurement for differential diagnosis—normal in viral, elevated in bacterial infections.

Systemic sclerosis (SSc) is an autoimmune connective tissue disorder characterized by damage to the skin, blood vessels, musculoskeletal system, and internal organs. Its pathogenesis is driven by microcirculatory disturbances, inflammation, and generalized fibrosis [1]. Clinical forms include limited, diffuse, and overlap SSc. While internal organ involvement occurs across all forms, its severity and frequency vary. Cardiac involvement is reported in 7–35% of cases [2] and manifests as ischemic heart disease, myocarditis, pericarditis, arrhythmias, and conduction disturbances. Notably, cardiac rhythm and conduction disorders are independent predictors of malignant arrhythmias, which increase the risk of sudden cardiac death (SCD). Objective. To investigate the characteristics and types of arrhythmias and to identify potential predictors of their development in patients with systemic sclerosis within the Voronezh region. Materials and Methods. A retrospective analysis was conducted on medical records from patients in the Rheumatology Department of the Voronezh Regional Clinical Hospital №1 for the period of 2024–2025. Additionally, current scientific literature on cardiac involvement in SSc published from 2021 onwards was reviewed and analyzed. Results. The study established the prevalence and specific types of arrhythmias among SSc patients and identified potential predictors contributing to their development. Conclusion. This study confirms that arrhythmias are a frequent manifestation of cardiac involvement in the SSc patient population of the Voronezh region. This necessitates timely detection through regular ECG monitoring for all patients diagnosed with systemic sclerosis.

Dentistry is actively developing. This is due to the communication of doctors, including those working in different countries. Digital translators are used by practicing doctors who do not speak a foreign language. However, the specifics of translating German-language dental texts into Russian have not yet been studied, although dental vocabulary creates additional difficulties for machine translation. The purpose of the work was to identify and analyze the problems that arise in the digital translation of German dental texts into Russian. The materials used were the works of domestic and foreign authors on the digital translation of German-language dental terminology. Data systematization and analysis are used as methods. Results. One of the problems is ignorance of specialized terminology, leading to literal calculation or distortion of meaning. Abbreviations are often omitted or misinterpreted due to their inconsistencies with their Russian counterparts. Grammatical constructions of the German language, especially those with the modality of necessity, are transmitted with errors that lose their original meaning. The quality of translation of coherent texts into Russian is inferior to translation into Romance languages due to the lower volume of relevant training data.Thus, the problem of machine translation of German-language dental texts into Russian is urgent. The revealed lexical and terminological inaccuracies, errors in the translation of abbreviations and grammatical distortions can negatively affect the quality of the dentist's work when studying professional information.

Varicella-ZosterVirus persists lifelong in the bodyafterinitialinfection, itsreactivation causes herpeszoster.Despite its highprevalence(556.8per100,000populationin2025), there is nounified severity scale exists, complicating therapy and outcome prediction. Objective: to evaluateclusteranalysisfordeterminingherpeszosterseverity usingclinicalsymptomsandlaboratorydata.Materials and methods: 40 patients with OH were included in the study. Toobjectivelyassess the clinicalstatusandseverity of the disease, a two-stageclusteranalysis(CHAIDmethod) applied using three variables: the area of the skinlesion, the intensity of painsyndrome(VAS), andinterleukin-6 level.Results:Threestableclusters were identified(silhouettemeasure0.6). The firstcluster(37.5% of patients)-mild, was characterized by minimalvalues of indicators(151cm2,6points,4.2pg/ml). The secondcluster(40% of patients)reflected the averageseverity(169.5cm2,8points,6.9pg/ml). The thirdcluster(22.5% of patients)unitedpatientswithseverecourse(197cm2,10points,12pg/ml). Differences between groups were statistically significant(p<0.05).Conclusions: Cluster analysis allows us to objectively stratify patients with herpes zoster by severity (mild, moderate, severe), which can be used to optimize therapy and predict outcome.

Background. The issue of acute respiratory viral infections (ARVI) in children remains significant due to the high incidence of co-infections, with reported rates ranging from 20% to 80%, which necessitates regional monitoring. Objective. Analysis of epidemiological data in children with mixed viral infections hospitalized at the regional hospital in Voronezh. Materials and methods. A retrospective analysis was conducted of 6,016 medical records of children with laboratory-confirmed etiology of ARVI for the period 2022–2023. Results. The proportion of mixed infections remained stable over the two-year period (approximately 8.5%). The highest rate of co-infection was recorded during the winter months (November–January). Children aged 1 to 3 years constituted the largest age group (35.3%). It was found that in 2022, the proportion of children under one year of age was significantly higher than in 2023 (25% vs. 12.2%, p<0.05), whereas in 2023, children older than 6 years were more frequently affected (25.2% vs. 12.9%, p<0.05). The leading etiological agent in the associations was rhinovirus, whose proportion increased significantly from 23.5% in 2022 to 31.4% in 2023 (p<0.05). The most common combination was rhinovirus with adenovirus. Conclusion. The data obtained underscore the importance of etiological characterization of ARVI for optimizing diagnosis and treatment, as well as the need for continued monitoring of viral circulation.

Background: The incidence of atrial fibrillation (AF) in ST-segment elevation myocardial infarction (STEMI) ranges from 2% to 23%, but data on AF recurrence remain limited.Objective: To assess the prevalence of AF recurrence after STEMI and identify factors associated with its recurrence.Materials and methods: A retrospective analysis of 45 medical records of patients with STEMI and newly documented paroxysmal AF was conducted.Results. The recurrence rate of AF in patients after STEMI is 51.1%. Factors associated with recurrence include older patient age, transmural myocardial infarction, anterior myocardial infarction, and hemodynamically significant atherosclerosis in other coronary arteries, as well as a higher prevalence of hypertension, diabetes, stage 2 obesity and higher, and stenotic atherosclerosis of the peripheral arteries. Patients with recurrent AF after STEMI have larger left atriums, higher pulmonary artery systolic pressure, and lower left ventricular ejection fraction. Patients with recurrent AF also had higher levels of troponin, N-terminal brain natriuretic peptide, and high-sensitivity C-reactive protein at admission, and worse renal filtration function at discharge.Conclusion. Clinical, anamnestic, laboratory, and instrumental factors associated with recurrence of AF after a first-time paroxysm following acute ST-segment elevation myocardial infarction were identified.

The prevalence of bronchial asthma (BA) increases every year; therefore, the ability to correctly diagnose and treat BA is a key task of modern medicine. The aim. To study the level of knowledge of medical university students regarding BA therapy. Materials and methods. Within the framework of the multicenter study ASSA-IV, an anonymous survey of 487 4th–6th-year students of the pediatric and general medicine departments from five medical centers in Russia was conducted. The questionnaire included questions about asthma attack relief and the treatment of mild BA. The obtained results were compared with data from the III phase of ASSA, which involved 486 students. Statistical data processing was carried out using the Chi-square test. Results. The first question about attack relief was answered correctly by 70.0% of students (in ASSA-III – 74.9%, p=0.089). A correct answer to the second question about mild BA therapy was given by 39.6% (in ASSA-III – 15.4%, p<0.001). The average level of correct answers in ASSA-IV was 54.8% compared to 45.15% in the previous phase. The most frequent errors were: choosing ICS for attack relief (24.8% in ASSA-IV and 18.5% in ASSA-III) and prescribing SABA as needed for mild BA (53.6% and 75.5%, respectively). In both phases, statistically significant differences were found between the answers to the two questions (p<0.001). Conclusion. Uneven assimilation of the material was revealed: students are better oriented in emergency BA therapy than in the principles of basic treatment for mild asthma.

The study analyzed the genetic polymorphism of beta-2-adrenergic receptors and the clinical course of bronchial asthma. The study included 58 patients with bronchial asthma hospitalized in the pulmonary department of the private healthcare institution "Russian Railways-Medicine" in Voronezh in 2023-2025. As a result of the study, the value of the coding part of the ADRB2 gene was shown (replacement of 46A with 46G at the 16 amino acid position, arginine (Arg16) with glycine (Gly16) and replacement of 79S with 79G at the 27 amino acid position, glutamine (Gln27) with glutamic acid (Glu27) for the variability of the response to the conducted pharmacotherapy. The inheritance of the 46G allele of the ADRB2 gene (homozygous carriage of Gly16Gly) was associated with a phenotype of a more severe course of the disease and a high level of bronchial reactivity. Inheritance of the 79G allele (homozygous carriage of Glu27Glu) contributed to less severe manifestations of the disease. The combination of 46G variants and 79C ADRB2 gene sequence in asthma patients was a confounding factor for bronchodilator response. The isolated haplotype has prognostic significance for the prediction of the effectiveness of the course of bronchial asthma. 

Acute otitis media is one of the most common pathologies of ENT organs in pediatric otorhinolaryngology. The rational choice of medications and the application of otorhinolaryngological procedures (catheterization and inflation of the Eustachian tube, massage of the eardrums) contribute to the suppression of bacterial inflammation and the restoration of Eustachian tube function. Aim. To study the structure of medication prescriptions used in the inpatient treatment of otitis in children for the period January-March 2024, from the perspective of current clinical guidelines and official prescribing information. Materials and Methods. An analysis was conducted of the medical records of 154 patients (children under 18 years old) who received treatment in the ENT department of a hospital in Kursk. Results. Seventeen patients were admitted with a diagnosis of "Unilateral acute purulent otitis media. Conductive hearing loss, grade 1." The largest number of children was observed in the 6–12 years age group (52.9%). All patients underwent Eustachian tube catheterization with the administration of dexamethasone + hyaluronidase, pneumomassage, Eustachian tube inflation, and also received turundas with ofloxacin. Among antibacterial drugs, cefotaxime was prescribed most frequently (in 64.7% of cases); loratadine predominated in the structure of antihistamine prescriptions (75%); and in the analgesic group, metamizole sodium was most common (80%). The leading pharmacotherapy regimen was mometasone furoate + levocetirizine (41.1% of all prescriptions). Conclusion. Comprehensive inpatient therapy for acute otitis media, based on clinical guidelines and official drug instructions, is necessary for successful recovery and the prevention of complications.

Background. Glucose-lowering therapy (GLT) is aimed at improving patients' quality of life and complication preventing. Hypoglycemic episodes are a common complication of HLT. In older and frail patients, hypoglycemia is associated with an increased risk of falls and mortality, as well as functional decline and cognitive impairment. Several Russian and international studies suggest that a significant proportion of older adults with type 2 diabetes mellitus (T2DM) may be exposed to excessive GLT. In these cases, deprescribing represents a promising strategy for preventing hypoglycemia. Objective: To investigate the real-world clinical practice of hypoglycemic control deprescribing in older adults at the Smolensk Gerontology Center. Materials and Methods. A retrospective cross-sectional pharmacoepidemiological study was conducted at the Smolensk Gerontology Center.Results. An analysis of the treatment regimens of the study patients revealed 15 cases of successful deprescribing. These interventions included switching patients to simpler insulin regimens, transitioning them from insulin to synthetic drugs with a lower risk of hypoglycemia, and discontinuing pharmacological therapy. Conclusion. This study demonstrates that deprescribing is a feasible and promising method for optimizing glycemic control in older adults with T2DM. By identifying patient characteristics and indications for deprescribing, these results provide a practical framework for reducing potentially inappropriate GLT.

Adequate B-vitamin status is important for energy metabolism, aerobic performance, and athletes’ adaptation to physical exertion. The aim of the study was to investigate the relationship between plasma levels of vitamins B₁, B₂, and B₆ and the parameters of cardiopulmonary exercise testing in elite ice hockey players during the preseason period. The study included 42 elite athletes. Plasma concentrations of thiamine, riboflavin, and pyridoxine were determined using high-performance liquid chromatography coupled with tandem mass spectrometry. Functional status was assessed using a cycle ergometer test with gas analysis. It was found that in 50% of those examined, the level of vitamin B₁ was below the reference values; for vitamin B₆, this was observed in 30.9%, and for vitamin B₂, in 9.5%. The mean VO₂max value was 42.49±5.45 mL/kg/min. A moderate positive correlation was identified between vitamin B1 concentration and VO₂max (r=+0.43; p<0.05). Athletes with combined B-group vitamin deficiency demonstrated lower aerobic performance compared with participants without deficiency. The results obtained confirm the relevance of laboratory monitoring of vitamin status in athletes for the subsequent personalization of nutritional support.

Allergic rhinitis (AR) is a common condition affecting both adults and children. The most frequently used medications for mono- and combination therapy of AR are oral H1-antihistamines. Current clinical guidelines do not provide algorithms for selecting second-generation antihistamines based on their pharmacological characteristics. Developing personalized approaches to prescribing second-generation antihistamines may reduce variability in pharmacotherapeutic response and enhance the effectiveness of allergic rhinitis treatment. The aim. To compare the clinical efficacy of initial pharmacotherapy with cetirizine, bilastine, and rupatadine for moderate persistent seasonal AR in children. Materials and Methods. A four-week open-label prospective randomized comparative study was conducted to evaluate the efficacy of antihistamines (cetirizine, rupatadine, and bilastine) in parallel groups of children with moderate persistent seasonal AR. Treatment efficacy assessment included evaluating the disease's impact on well-being using a visual analog scale (VAS), assessing the severity of AR symptoms using the rhinoconjunctivitis total symptom score (r-TNSS), and quality of life assessment (RQLQ). Additionally, the number of days on monotherapy with antihistamines in each group was recorded, along with the frequency of unplanned visits due to worsening conditions and the rate of therapy escalation (STEP-UP) due to loss of control. Conclusion. Second-generation antihistamines (cetirizine, bilastine, and rupatadine) demonstrated comparable clinical efficacy in the initial treatment of early symptoms in children with persistent seasonal AR. In patients with multimorbid AR (including asthma), initial therapy with rupatadine showed higher clinical efficacy compared to cetirizine regarding the assessment of the disease's impact on well-being (p<0.05). 

Analyzing medication consumption in a healthcare facility is essential for optimizing procurement. It reveals actual drug needs, enabling effective inventory management and ensuring continuous operations. To analyze medication consumption in an oncology clinic, data on the receipt of medications, excluding chemotherapeutic agents, was reviewed at the respective medical facility. It was found that the largest category is Group V Other Drugs according to the Anatomical Therapeutic Chemical Classification System, accounting for 43.81% of total expenditures. Within this group, the most significant subgroup is contrast agents, accounting for 90.76% of expenditures within the group. Less significant are other therapeutic agents (4.71%), diagnostic radiopharmaceuticals (2.95%), and diagnostic drugs (1.51%). Other non-therapeutic agents and therapeutic nutrition account for a very small share (0.06%) and 0.01%, respectively. The prevalence of this group is determined by its subgroups and, consequently, the specific nature of the medical organization in question, which specializes in providing care to cancer patients. The predominant subgroups are primarily necessary for high-quality diagnostics of oncological diseases, monitoring of treatment, and maintaining patient life during and after surgery.

An important component of the treatment of post-stroke patients is pharmacotherapy, the effectiveness of which depends on the functioning of the biotransformation system. The CYP2D6 isoenzyme is responsible for the metabolism of 20 to 30% of drugs, including those used in drug therapy for stroke. The CYP2D6*3, CYP2D6*4 and CYP2D6*10 alleles make an important contribution to the interindividual differences in response to pharmacotherapy. The aim. To study the prevalence of alleles and genotypes for allele variants CYP2D6*3, CYP2D6*4 and CYP2D6*10 in stroke patients in the Arkhangelsk region. Materials and methods. Molecular genetic analysis of CYP2D6 gene alleles was performed in 81 patients with stroke treated in the neurology department of the regional vascular center of the State Budgetary Healthcare Institution of Arkhangelsk Region "First City Clinical Hospital named after E.E. Volosevich". Analysis of CYP2D6*3 (A2549del, rs4986774), CYP2D6*4 (G1846A, rs3892097), CYP2D6*10 (C100T, rs1065852) variants was performed on a BioRad CFX96 Touch amplifier using SNP-Screen kits (Synthol LLC, Russian Federation). Results. According to the polymorphic locus A2549del of the CYP2D6 gene, the distribution of genotypes is: C/C - 67.9%, C/T - 30.86%, T/T - 1.24%. According to the polymorphic locus G1846A of the CYP2D6 gene, the distribution of genotypes is: G/G - 74.07%, G/A - 25.93%. According to the polymorphic locus A2549del of the CYP2D6 gene, the distribution of genotypes is: A/A - 98.77%, A/delA - 1.23%.  Conclusions. Wild homozygous genotypes for allelic variants A2549del, G1846A, and C100T of the CYP2D6 gene prevailed in stroke patients in the Arkhangelsk region.

Acne vulgaris is a chronic skin disease characterized by the formation of comedones, papules, pustules, and scars, cysts, and nodules in more severe cases.The clinical picture of acne can range from mild comedonal form to severe inflammatory cystic acne localized on the face, chest, and back [1].According to the results of the study, the overall prevalence of acne made 20.5%. The highest rate was recorded in the age group of 16–24-year-olds – 28.3%. At the same time, a significant spread of the disease among adult population was identified: in the age category of 25–39-year-olds, acne was diagnosed in approximately every fifth person examined, which confirms the tendency towards the increase of acne disease in adults [2]. Acne is considered a multifactorial disease, in the pathogenesis of which hypersecretion of sebum, follicular hyperkeratosis, inflammatory response, and colonization by Cutibacterium acnes play a key role [3].The purpose of the study is to assess the changes in structure of drugs prescriptions (DP) for the treatment of moderate to severe acne in the State Budgetary Healthcare Institution of the Republic of Crimea "Clinical Dermatovenerological Dispensary" (GBUZ RK "KKVD") for the period from January 1, 2021 to December 31, 2024, to assess the outcome of treatment with different drug therapy regimens.Study materials: medical records of patients with moderate or severe acne who received medical care in inpatient conditions in GBUZ RK "KKVD". The methods applied during the study were systematization method, comparative and structural analysis.The study results reflect structural changes in the drug prescriptions (DP) for acne treatment associated with the growing prevalence of prescribed retinoid-group drugs replacing conventional antibiotic (AB) therapy. Changes in the structure of DP of- AB group are conditioned by several factors: the increased likelihood of antibiotic resistance and an increased risk of disease recurrence which are caused by the chronic nature of the condition. The analysis of cases of acne medication treatment revealed the increase in frequency of combined treatment methods application. The combination of antibacterial drugs with retinoids provides a comprehensive effect on the key pathogenetic mechanisms of acne and contributes to correction of the disease clinical manifestations.Conclusion. The results of the study demonstrate significant changes in the structure of drugs prescription for acne treatment over the considered period. By the end of the analyzed period, the group of retinoids (systemic and topical treatment) became the leading prescription. However, the use of drugs of this group should be accompanied by a preliminary assessment of the risks of adverse reactions and considering contraindications.

Due to the growth of the pharmaceutical market and the expansion of the range of medicinal products, the number of drug-induced side effects is inevitably increasing. Among these, allergic reactions stand out as they are unpredictable, dose-independent, and unrelated to the main pharmacological action of the drug. Objective. To identify the groups of drugs and substances to which sensitization was most frequently observed, based on the results of laboratory allergy tests conducted at the "Center for Clinical Pharmacology and Pharmacotherapy" in Stavropol for the year 2017. Materials and Methods. A retrospective analysis was performed on 2570 reports of allergy tests for medicinal products and dietary supplements, conducted at the "Center for Clinical Pharmacology and Pharmacotherapy" in Stavropol during 2017. To detect the immunological mechanisms of hypersensitivity to drugs, laboratory diagnostic methods were used - the myeloperoxidase test (MPT) and the determination of circulating immune complexes (CIC). Results. Immunological mechanisms of hypersensitivity were identified for 836 items - of these, 165 (19.7%) were local anesthetics, 154 (18.4%) were antibiotics, and 56 (6.7%) were NSAIDs. Conclusion. According to the results of laboratory allergy tests, sensitization to local anesthetics, antibiotics, and non-steroidal anti-inflammatory drugs was most frequently observed.

Acute appendicitis is one of the most common pathologies of the abdominal cavity. Approximately 20-30% of cases of acute appendicitis have an atypical clinical presentation. Timely diagnosis of this condition is crucial. According to clinical guidelines for the treatment and diagnosis of acute appendicitis, computed tomography is not the preferred method for diagnosing acute appendicitis, but it is recommended in complex cases. The aim of this study is to evaluate the diagnostic value of computed tomography in the case of a patient with an atypical clinical presentation of acute appendicitis. The patient's "atypical" onset of the disease, which was associated with intense physical activity, and their complaints of intense pain in the lumbar region with irradiation to the right iliac region, as well as the absence of nausea, vomiting, fever, normal urination, and unchanged stool, which are not typical for acute appendicitis, were insufficient for a preliminary diagnosis. Therefore, additional diagnostic methods were performed, including multislice computed tomography. The multislice computed tomography of the abdominal cavity revealed a dense tissue in the area of the cecal dome, an increase in the diameter of the appendix to 22-23 mm, an uneven thickening of its wall, and an increase in the regional lymph nodes. No fluid or free gas was detected. As a result, a preliminary diagnosis of acute appendicitis was made, which was confirmed during the surgery, which was a video-assisted laparoscopic appendectomy, based on the macroscopic findings and subsequent histological analysis. Therefore, relying solely on patient complaints, physical examination, and laboratory findings for the diagnosis of acute appendicitis with an atypical location of the appendix and an atypical clinical presentation is unreliable and should be supported by instrumental diagnostic methods in complex cases.

The Covid-19 pandemic continues to be a global health concern. Initially considered to be an exclusively respiratory infection, coronavirus disease is now recognized as a systemic disease affecting various organs and tissues, including the kidneys. High expression of receptors Angiotensin-converting enzyme 2 in the kidney tissue - Bowman's capsule, tubular epithelium and vascular endothelium - determines the tropism of the virus towards the kidneys and explains the wide range of renal complications. The aim. Studying changes in the kidneys caused by Covid-19 using radiological diagnostic methods. Materials and methods. The study analyzes domestic and foreign publications from the past ten years. Results. The work is set, that kidney damage in coronavirus infection is manifested by functional and structural disorders. Computed tomography allows for the detection of hypodense areas of the parenchyma, reduced density, and vascular complications. Magnetic resonance imaging provides an assessment of fibrosis and edema. Ultrasonic diagnostics with Doppler imaging and contrast enhancement are effective for early diagnosis of perfusion disorders and dynamic monitoring.

This article presents an instant method of microbiological diagnostics in surgical practice, which is based on the dependence of the time of development of clinical signs on the type of microorganism. This principle can establish a relationship between the temporal dynamics of the development of the infectious process and the probable etiological structure of the pathogens. For example, acute processes with rapid development within a few hours are associated primarily with gram-positive coccal flora, while infections with a prolonged, multi-day course are characteristic of gram-negative bacillary microorganisms. Modern surgical practice is characterized by the increasing complexity of managing patients with infectious complications, which is due to the progressive growth of antimicrobial resistance in microorganisms. In these conditions, the strategy of empirical antimicrobial therapy demonstrates a decreasing effectiveness of treatment, dictating the need for the implementation of quick-to-use diagnostic approaches. The algorithm for primary microbiological diagnosis becomes particularly important, as the time required for the development of clinical signs depends on the type of microorganism in surgical practice.

Statistical data and literary sources regarding the effectiveness, safety, and long-term effects of COVID-19 vaccines have been analyzed. Currently, the issue of the need for vaccination is quite acute. Many people are opposed to regular vaccinations, and parents are opposed to vaccinating their children. This is often due to the active transmission of the harm of vaccinations through social networks and the lack of objective knowledge among the population. In this regard, a generation is growing up that is not immune to certain dangerous and severe viral infections. This population group can become a source of these diseases, which increases the likelihood of an increase in morbidity and the development of epidemics several times.  Over time, more and more new and more aggressive strains of viruses appear, so this issue will always be relevant. Discussion of such serious infections as coronavirus requires the involvement of the entire population, namely, issues of specific and non-specific disease prevention.  To better clarify this topic, statistical data and literature sources on the effectiveness, safety and long-term effects of vaccines against COVID-19 were studied. 

The problem of urogenital candidiasis (UGC) remains extremely relevant due to its high prevalence among young people, especially under conditions of intensive academic process. Medical students are exposed to a specific set of factors (chronic stress, sleep and nutritional disorders, irrational antibiotic therapy) that contribute to the development and chronization of the disease, but the epidemiological features in this group have been insufficiently studied. A detailed study of the causes of this pathology is necessary not only for its prevention but also to improve treatment outcomes, preventing a relapsing course. The role of bacterial and behavioral factors in the development of candidiasis is not always considered a leading trigger, but it requires careful study, as their negative impact on the formation and progression of the disease cannot be ruled out.

Relevance. Nosocomial obstetric sepsis is a life-threatening condition of a pregnant woman, which leads to the development of multiple organ failure. The presented disease is transmitted to a woman in an obstetric hospital, maternity hospital or perinatal center through wound surfaces during gynecological examination, birth canal during natural childbirth and incisions during cesarean section. According to world statistics, sepsis in a pregnant woman occurs with a frequency of 2 cases per 100-110 thousand births. Goal. To study the causes, pathogenesis, prevention and possible outcomes of nosocomial obstetric sepsis. Materials and methods. Statistical data and scientific articles taken from the Cyberleninka and E-library information bases were analyzed. Results. The main etiological factors of sepsis development in obstetric hospitals, maternity hospitals, and perinatal centers include Gram-positive (Staphylococcus aureus, Streptococcus pyogenes, Streptococcus agalactiae) and gram-negative microorganisms (Escherichia coli), which have adaptations in the form of enzymes, toxins, proteins that determine the course, severity, and subsequent outcomes of the disease. Conclusion. Nosocomial obstetric sepsis is an urgent problem in the healthcare sector, despite the improvement of the epidemiological control system in obstetric hospitals and perinatal centers, compliance with diagnostic algorithms based on APACHE II, SOFA assessment systems, as well as due to timely microbiological examination of biomaterials of a pregnant woman (taking a smear from vaginal secretions, wound surface), which contributes to to improve prognosis and preserve women's reproductive health.

Military surgery has undergone a long evolutionary process in the use of antibiotics, starting with the practice of Academician N.N. Burdenko, who pioneered the widespread use of antiseptics and sulfanilamides during the Great Patriotic War. Further development has led to the widespread use of antibiotics from various groups, the improvement of principles for the prevention and treatment of wound infections, the creation of antibiotic therapy standards, and the development of individualized drug regimens based on the type of injury, the nature of the infection, and the epidemiological situation. Modern achievements in the fields of microbiology, pharmacokinetics, and molecular biology make it possible to optimize the use of antibiotics, minimizing the risks of microbial resistance and drug side effects, and improving the quality of medical care for injured military personnel and their survival rates.

Relevance. Cesarean section (CS) is the most common surgical procedure in obstetric practice. Globally, the frequency of CS is constantly increasing: between 1990 and 2014, the global average increased from 7% to 19%, and in the Russian Federation, the frequency of CS reached 30% in 2018. Goal. To study the causes and possible outcomes of wound infection during cesarean section surgery. Materials and methods. Statistical data and scientific articles taken from the CyberLeninka and E-library information bases were analyzed. Results. The etiological structure of the pathogens was established: the leading role is played by Staphylococcus aureus, representatives of the order Enterobacterales, Pseudomonas aeruginosa and strict anaerobes (Peptostreptococcus, Bacteroides, Prevotella), which in 60-70% of cases are isolated in polymicrobial associations. The main clinical outcomes of wound infection are diverse: from local manifestations (suture failure, suppuration) to severe generalized forms (postpartum endometritis, obstetric peritonitis, sepsis), as well as long-term consequences, including the formation of an incompetent scar on the uterus and the associated risks in subsequent pregnancies. Conclusion. The problem of wound infection during cesarean section remains highly relevant in modern obstetrics, due to three key factors: a steady increase in the frequency of abdominal delivery, a significant proportion of infectious complications in the structure of maternal morbidity and mortality, as well as continuing difficulties in prevention, diagnosis and treatment.

The role of the microbiome in carcinogenesis and the progression of malignant neoplasms is receiving increasing attention in contemporary oncology. Head and neck squamous cell carcinoma (HNSCC) ranks among the most prevalent malignancies of the upper digestive tract and is distinguished by its heterogeneous clinical behavior and frequent resistance to standard therapeutic modalities. This review synthesizes and systematizes findings from the literature published between 2024 and 2026 on the involvement of intratumoral and oral microbiota in HNSCC. Epidemiological studies confirming the association of specific microbial taxa with disease risk are examined, and the dysbiotic alterations present in tumor tissue and the saliva of affected patients are characterized. The key molecular mechanisms underlying bacterial interaction with the tumor microenvironment—including effects on cellular proliferation, migration, and immune modulation—are discussed. Particular emphasis is placed on clinicopathological correlations, the prognostic value of microbial markers, and the potential of microbiome-targeted interventions to enhance the efficacy of antitumor therapy.

The article presents a comprehensive analysis of current data on Coxsackieviruses — widespread RNA-containing enteroviruses with high tropism for various tissues and significant clinical polymorphism. Key aspects of the biology of these pathogens are examined, including their classification into groups A and B, the molecular mechanisms of interaction with the cellular CAR receptor, and its role in pathogenesis. The epidemiology of the infection is detailed, with emphasis on global circulation, seasonality, transmission routes, and an analysis of the epidemiological situation in the Russian Federation using the 2024 outbreak as an example. Focus is given to the wide spectrum of clinical manifestations — from typical syndromes (hand-foot-mouth disease, herpangina) to severe, life-threatening conditions (myocarditis, meningoencephalitis, generalized neonatal infections, myositis) and their possible association with the development of autoimmune processes. Modern approaches to laboratory diagnostics are described, including serological methods (ELISA), molecular-genetic methods (RT-PCR), and virological typing, as well as the role of instrumental methods in assessing complications. Due to the absence of a specific vaccine and etiotropic therapy, the importance of non-specific prevention, sanitary-hygienic, and anti-epidemic measures is emphasized. The conclusion is drawn about the need for continuous molecular-epidemiological surveillance and further study of pathogenesis to develop effective infection control methods.

Liver trauma is a common cause of mortality in abdominal injuries, requiring improved hemostasis and regeneration. Objective. To study liver reparative processes after BioGlue application combined with low-intensity laser irradiation (LILI) in an experiment. Materials and methods. Experiments involved 20 rats with left liver lobe wounds (0.5×0.3×0.2 cm). Animals were divided into two groups: Group 1 received BioGlue only; Group 2 received BioGlue with intraoperative laser therapy (660–670 nm, 25 mW, 5 min). Autopsy with macroscopic and histological evaluation of the injury zone was performed on days 3, 14, and 28. Results. No mortality occurred. On day 3, both groups demonstrated eosinophilic adhesive mass with leukocyte infiltration and hepatocyte fatty degeneration, without intergroup differences. By day 14, remnant debris encapsulation was observed in Group 2. On day 28, the LILI group showed encapsulated adhesive fragments with giant multinucleated cells, while controls exhibited persistent detritus without active demarcation. Liver tissue outside the injury zone recovered normally. Conclusion. LILI does not accelerate BioGlue resorption but promotes foreign material encapsulation, supporting further investigation of combined hemostatic agents and physical therapies for parenchymal organ injuries.

A lot of research has shown the negative effect of bisphenol A on the functioning of male and female reproductive systems. At the same time long-term effects of this endocrine disruptor are currently attracting increasing attention. Of particular interest is the chronic exposure to low doses of bisphenol A and potential manifestation of its effects in subsequent generations, including effects on early embryogenesis. The aim. Analysis of the parameters of early embryogenesis of Wistar rats under chronic exposure to low doses of bisphenol A in the F3 generation obtained through the maternal line. Materials and methods. The experimental group was formed from preimplantation embryos of F3 generation rats (n=17) obtained through the maternal line from female F0 generation rats exposed to chronic exposure to bisphenol A for 45 days at a dose of 25 micrograms/kg of body weight per os before pregnancy, and intact males. The embryos obtained from intact laboratory animals that were not exposed to bisphenol A (n=32) were used as a control group. The embryos were collected on the 3rd day of embryonic development and then cultured in vitro until the 5th day. The parameters of early embryogenesis were evaluated at collection and every 24 hours thereafter. Conclusion. The results obtained on the long-term embryotoxicity of bisphenol A on preimplantation embryos, manifested as a slowdown in cleavage, a decrease in the percentage of embryo compaction, and a reduced blastocyst rate in F3-generation rats compared with the control group, these effects may be mediated by epigenetic mechanisms.

Limb-girdle muscular dystrophy R9 (LGMD2I/R9) is frequently complicated by life-threatening cardiac and respiratory failure. Due to the development of AAV-based gene replacement therapy, careful validation of animal models is required. In the present study, we investigated the dynamics of structural changes in the myocardium and diaphragm of P448L line mice. Animals were divided into 3- and 8-month-old age groups. Histological (H&E, Mallory's method) and immunohistochemical (CD45 for inflammation detection, MYH7 for slow muscle fibers visualization in the diaphragm) methods were used, followed by morphometry. The results demonstrated the late development of cardiomyopathy (an increase in the pool of CD45+ cells and the area of cardiosclerosis by 8 months) and massive fibrotic degeneration of the diaphragm.

Abstract. This paper presents an analysis of the current capabilities of immunohistochemical diagnosis of neuromuscular diseases (NMD) using desmin and dystrophin markers. It is shown that the wide heterogeneity of clinical manifestations and the similarity of symptoms in various forms of NMD make standard morphological methods insufficiently specific, especially in the early stages of the pathological process. Particular attention is paid to the structural and functional characteristics of desmin, an intermediate filament protein that links the contractile apparatus to the sarcolemma and mitochondria. The molecular organization of dystrophin is examined as a component of the dystrophin-associated glycoprotein complex, connecting the cytoskeleton to the extracellular matrix. It is noted that mutations in the genes encoding these proteins lead to severe hereditary pathologies: dystrophin deficiency is associated with Duchenne muscular dystrophy, while impaired desmin assembly underlies desminopathies, accompanied not only by skeletal muscle weakness but also by severe cardiomyopathies. The diagnostic value of immunohistochemical examination of muscle biopsies is analyzed: the detection of desmin aggregates allows for the verification of myofibrillar myopathy, and the complete absence or mosaic staining of dystrophin differentiates Duchenne dystrophy from the more benign Becker form. It is emphasized that the identified patterns demonstrate the functional interaction of these protein systems; however, a final diagnosis requires mandatory confirmation by molecular genetic methods. The obtained data indicate the need for an integrated approach to the diagnosis of NMD, where immunohistochemistry serves as a key link between the clinical picture and genetic testing, allowing for the determination of prognosis and patient management strategies.

Introduction. Headaches are one of the leading drivers of reduced productivity and impaired quality of life in the world. Purpose. A study of the level of awareness of students of RostSMU about the degree of impact of headache on everyday life, combined with an assessment of the popularity of non-drug strategies for the prevention and management of headache, taking into account the criterion of gender. Materials and methods. The sample population is represented by 358 respondents, divided by gender: male students (n = 96) and female students (n = 262). Inclusion criteria are students of 1-3 courses of RostSMU. The main research methods are online questionnaire, data analysis and comparison method. Results. A survey of students revealed the high relevance of the problem of tension headache. The headache effect index on the HIT-6 scale was 57 points in boys (pronounced influence) and 62 points in girls (severe influence), while girls more often noted reduced concentration ("very often," index 3.27). Respondents rate the importance of non- pharmacological prophylaxis highly (mean score 4.1-4.2 out of 5), prioritizing sleep hygiene and physical activity. Conclusion. Students of RostSMU demonstrate an average level of knowledge about headache with a pronounced and severe effect on daily activity (HIT-6: 57 and 62 points). Gender differences identified. A positive attitude is noted (intensity indices 4.10 and 4.19 on a five-point scale) to non- pharmacological prevention.

Multiple sclerosis (MS) is one of the most common disabling diseases of the central nervous system in young and middle-aged people. Along with motor and cognitive impairments, autonomic dysfunction significantly reduces the quality of life of patients, but its structure and clinical significance are often underestimated. The aim. To assess the frequency, nature, and severity of autonomic disorders in patients with multiple sclerosis, as well as their relationship with psycho-emotional status. Materials and methods. The study involved 58 patients with various types of MS. Clinical and neurological examination using the EDSS scale, questionnaires (COMPASS-31 for autonomic symptoms, PHQ-9 for depression, and GAD-7 for anxiety), and active orthostatic and clinostatic tests were performed. Results. A high burden of autonomic symptoms was detected in the majority of patients (median COMPASS-31 score 26.5), mainly due to orthostatic intolerance and gastrointestinal disorders. Postural orthostatic tachycardia syndrome (POTS) was diagnosed in 8.6% of patients. The severity of autonomic symptoms correlated significantly with anxiety (ρ=0.31) and depression (ρ=0.32) scores, but not with the EDSS disability score. Conclusions. Autonomic disorders in MS are a frequent and clinically significant manifestation closely related to the psycho-emotional state of patients, necessitating a comprehensive approach to the diagnosis and management of these patients.

The article is devoted to a study conducted in which a solution was sought to the problem of inefficiency in the procurement of medical equipment in medical organizations. The concept of lean management is used as a methodological basis, in particular, the analysis tool "Muda" (Japanese "losses"). The purpose of the study was the systematic identification and analysis of the main and most important types of losses characteristic of procurement activities in the healthcare sector.Based on a deductive approach, observation, document analysis, and interviews with employees of clinical and pharmaceutical departments, the classic types of losses were adapted to the specifics of medical procurement. As a result, six key issues were identified: overproduction (excessive procurement of medical equipment), waiting (time-consuming approvals), unnecessary processing (excessive administration), excessive inventory (illiquid or unclaimed medical equipment), unnecessary movements (inefficient work organization), and unrealized employee potential (ignoring the expertise of medical and pharmaceutical staff). Their causes and negative consequences for financial stability, operational activities, and the quality of medical care have been analyzed.In conclusion, the paper proposes practical ways to optimize the procurement process for medical equipment based on the principles of lean management: implementing the just-in-time and kanban systems, digitalizing processes, revising approval procedures, creating cross-functional working groups, and implementing KPIs for monitoring efficiency. This analysis provides a foundation for improving the medical equipment procurement system in healthcare organizations.

The relevance of the study is determined by the importance of organizing assistance to patients with post-COVID syndrome (PCS), while the pharmacy often becomes the first point of contact, which requires assessing the quality of awareness and counseling on this issue. The aim of the work was to determine the level of awareness about PCS among patients and pharmaceutical workers. Materials and methods. A cross-sectional study was conducted using an anonymous survey of patients (n=162), pharmacists and pharmaceutical specialists (n=96) using author’s questionnaires. Results. A significant gap was revealed between awareness about PCS and the quality of counseling: more than 70% of patients and 87% of specialists know about the syndrome, but their knowledge is superficial. Patients tend to self-medicate or ignore symptoms and are dissatisfied with the assistance, while pharmaceutical specialists, despite the frequency of consultations, demonstrate low confidence in their recommendations. Thus, a deficit of structured knowledge and practical algorithms has been established in both groups. Conclusion. It was concluded that there is a need to optimize pharmaceutical counseling for post-COVID syndrome, develop standards and methods of pharmaceutical care, which will contribute to improving the quality of advisory assistance and will lead to a reduction in the medical and social consequences of the pandemic.

The liver plays a critically important role in metabolism, and liver diseases are widespread. Hepatoprotectors (HPs) are a key group of drugs for treating such pathologies. Objective. To conduct a comprehensive comparative analysis of the structure and dynamics of the hepatoprotector market at the federal level and in a local market (Kursk) to assess its supply and develop proposals for optimizing the product range. Materials and Methods. We performed content analysis, statistical analysis, and calculation of assortment coefficients based on data from the State Register of Medicines and pharmacy reference books. Results. The analysis revealed that the federal market (67 trade names, 95 medicinal products) is characterized by the dominance of ursodeoxycholic acid‑based drugs (48.42 %) and domestic manufacturers (69.47 %). The local market in Kursk, while maintaining the overall structure by ATC groups (breadth coefficient = 1), is characterized by a narrowed assortment (53 medicinal products) and a limited choice of dosage forms (fullness coefficient = 0.56), although it has a higher renewal index (0.75). Conclusion. The regional market requires expansion of the product range by including missing dosage forms and trade names available at the federal level to improve the accessibility and quality of pharmaceutical care.

Mucociliary clearance is an important mechanism for protecting our body from various viral and bacterial pathogens. The cilia responsible for mucociliary transport perform a motor function. When the ciliated epithelium is damaged due to injuries, bad habits, polyps, mechanical effects, or hormonal changes, the protective mechanism is disrupted, and chronic diseases of the ENT organs may occur. We conducted a saccharin test on patients in the Otolaryngology Department to determine how the ciliated apparatus of the nasal epithelium changes in patients with sinusitis. The advantages of the saccharin test include its simplicity, non-invasiveness, harmlessness, low cost, and accessibility, as well as its high reliability. The test is indicated for patients with suspected impaired function of the ciliated apparatus of the nasal epithelium. However, it is not recommended for children under the age of 3-5 years due to the difficulty of teaching them to follow the rules during the test. Additionally, the mucociliary clearance test can be performed using a charcoal test, which involves applying charcoal dust, mascara, carmine, polypropylene-based dyes, dyes dissolved in agar-agar, and other substances to the mucous membranes. The study took into account the individual characteristics of the patient, such as their bad habits, previous ENT diseases, injuries, and climatic conditions. The results of the study showed that the mucociliary clearance time in patients with sinusitis was significantly lower than in healthy individuals.

Currently, highly informative technologies for visualizing various structures of the skull and its formations are being widely introduced into otorhinolaryngology. With a variety of manipulations with the sphenoid sinus, the Zuckerkandl line serves as an approximate anatomical guideline, which is drawn from the anterior nasal spine to the middle of the free edge of the middle nasal concha. Often, the edge of the middle nasal concha is deformed, removed as a result of previous surgical interventions. In such cases, the reference point is the angle of the Zuckerberg line to the Target. To study the morphometric variability of the sphenoid sinus and the angle of the Zuckerkandl line according to MSCT data in different age groups, to identify and evaluate patterns affecting anatomical differences and their significance. Materials and methods. We studied MSCT studies of the paranasal sinuses of 110 patients (excluding people with inflammatory phenomena of the paranasal sinuses, who underwent surgery on the base of the skull, formations of the main sinus, injuries and deformity of the facial skeleton) who were treated at the Medical School No. 1 in the period from October to November 2025 at the age of 19 to 75 years. Results. During the study of MSCT data in different age groups, the morphometric parameters of the sphenoid sinus were analyzed. It was found that the angle of the Zuckerkandl line varies from 46.65° to 52.8° (according to the literature, 30° is assumed). The variability of the angle depending on the type of pneumatization, volume, and variants of the interdigital septum of the sphenoid sinus in different gender and age groups was noted. Conclusion. This study made it possible for the first time to consider the relationship between the approximate anatomical landmark of the angle of the Zuckerkandl line and the key morphometric parameters of the sphenoid sinus, taking into account age and gender, which is of practical importance in planning and improving the technique of operations on the sphenoid sinus.

Inverted papilloma occupies a "borderline" position between benign and malignant neoplasms: having a histologically benign structure, it is characterized by local destructive growth, a high tendency to recurrence (10-75% of cases after non-radical removal) and the potential for malignancy (association with squamous cell carcinoma in 5-15% of cases). Goal. To carry out a comprehensive analysis of the clinical and morphological characteristics of patients with inverted papilloma of the nasal cavity and paranasal sinuses. Methods. A retrospective analysis of the data of 24 patients (14 men, 10 women; age 32-82 years) with histologically verified inverted papilloma who were treated at the otorhinolaryngological Department of Voronezh Regional Clinical Hospital No. 1 in 2022-2025 was performed. Demographic indicators, the nature of the process, and histological signs were evaluated. Results. The disease was more often detected in men (58.3%). The peak incidence occurred in the elderly (60-74 years) — 41.4% of cases. Primary forms accounted for 54.2%, and recurrent forms - 45.8%, which confirms the high tendency of the tumor to grow again. Morphological examination was dominated by lymphocytic infiltration (70.8%); eosinophils and neutrophils were detected in 41.7% of cases. Signs of proliferative activity (mitosis) were noted in 41.7% of cases, metaplasia in 33.3%, atypia and acanthosis in 16.7% each. Conclusions. Inverted papilloma is characterized by a high recurrence rate (45.8%) and predominance in elderly men. Pronounced inflammatory infiltration and the presence of proliferative changes justify the need for a radical surgical approach, early diagnosis and long-term follow-up for timely detection of relapses and prevention of malignancy.

Modern medicine, despite tremendous advances in pharmacology and microbiology, has faced a challenge that has remained in the shadow of bacterial infections for decades. We are talking about mycotic damage to ENT organs, a pathology whose prevalence has increased several dozen times over the past thirty years. Whereas in the middle of the 20th century, mycoses of ENT organs were considered primarily as casuistic cases or individuals with immunodeficiency conditions such as Hiv, AIDS, today mycoses of ENT organs, including fungal sinusitis, account, according to various sources, from 15% to 40% in the structure of all inflammatory diseases of the upper respiratory tract and ear.

Laryngeal granuloma (LG) is an urgent interdisciplinary problem due to the high risk of relapse (up to 93%) and unclear etiology. The article provides a historical review and analysis of current views on the etiology and pathogenesis of LG. In addition to the well-established etiological factors such as gastroesophageal reflux disease and voice overuse, the article explores the role of psychogenic factors and chronic stress in the pathogenesis of the disease. The hypothesis about the key role of anxiety-depressive disorders and personality traits in the formation of the "psychosomatic" profile of patients with hypertension is substantiated. A pathophysiological mechanism has been proposed that links chronic stress, dysfunction in the hypothalamic–pituitary–adrenal cortex system, proinflammatory shifts, and the development of recurrent inflammation in hypertension. Goal. to study the effect of anxiety-depressive spectrum disorders (ADSD) on the development and recurrence of hypertension. Materials and methods. 90 patients with laryngeal granuloma (87 men, 3 women; the average age of men was 42.7±9.6 years, and of women was 61.7±6.5 years) who were treated at the L.I. Sverzhevsky Research Institute of Oncology were examined. Results. Based on the examination, five main clinical variants of ADSD were identified, which later served as the basis for a differentiated therapeutic strategy. Conclusion. The obtained data confirm the concept of the influence of chronic stress on the development and recurrence of LG through the formation of anxiety-depressive conditions.

Acute odontogenic periostitis of the jaws is a pressing issue in dentistry. In recent years, the incidence of this condition has increased by up to 40% in clinical dental institutions. This condition often leads to complications, such as abscesses and phlegmons of the maxillofacial region. The aim of this study was to investigate the clinical and etiologic factors contributing to the development of acute purulent periostitis of the jaws, based on an analysis of scientific literature and outpatient data. Materials and methods. An analysis of scientific data from literary sources and medical records of patients with this condition who sought emergency medical care was conducted. Results. Acute odontogenic periostitis of the jaw most often affects women aged 40-60. Furthermore, endodontic procedures are the main etiologic factor. Orthopedic appliances, specifically their improper installation, are considered a secondary etiologic factor. People with unhealthy habits, poor oral hygiene, and previous surgical interventions are at increased risk of developing odontogenic periostitis. Conclusion: The study identified the main factors in the development of acute odontogenic periostitis: poor dental treatment, poor oral hygiene, unhealthy habits, and inflammation after tooth extraction. Preventive measures are proposed and high-risk groups are identified.

 Neuroinflammation is regarded as one of the key pathogenetic mechanisms underlying neurodegenerative diseases. According to WHO data (2021–2025), dementia affects approximately 57 million people worldwide, with about 10 million new cases registered annually; by 2050, their number is projected to exceed 150 million. Alzheimer's disease accounts for up to 70% of dementia cases, while aggregate annual economic losses, including direct medical expenses and productivity losses, exceed $650 billion USD. Objective. To summarize and analyze contemporary data on the etiology, pathogenesis, and regulation of neuroinflammation. Materials and Methods. A meta-analysis of publications by domestic and foreign authors over the past 10 years was conducted, including original studies and review articles indexed in PubMed, Scopus, and eLibrary. Analytical-synthetic method, systematization, and comparative analysis were used. Results. It is shown that neuroinflammation is initiated by peripheral inflammatory signals through circumventricular organs and blood-brain barrier dysfunction. Microglia and astrocytes play a key role in implementing pro-inflammatory cascades. The mechanism of the cholinergic anti-inflammatory pathway, which represents a promising target for neuroinflammation correction, was examined.Conclusion. Neuroinflammation is a complex, polyetiological process developing as a result of the integration of systemic inflammation signals and neuroimmune dysregulation.

Background. In recent decades, there has been a steady increase in pathologies associated with hypersensitivity reactions worldwide. Allergic diseases, including bronchial asthma and atopic dermatitis, affect up to 30–40% of the population in developed countries. At the same time, the number of cases of autoimmune disorders is growing. Significant diagnostic difficulties are caused by pseudo-allergic conditions, which clinically resemble true allergy but occur without the involvement of immune mechanisms.
Objective. To perform a comparative analysis of the pathogenetic links of allergic, autoallergic and pseudo-allergic reactions, to determine their common features and fundamental differences.
Materials and methods. The work uses a review of scientific literature on pathophysiology and immunology for the period 2023–2026. Textbooks, original articles in peer-reviewed journals, as well as official documents of the WHO and the Ministry of Health of the Russian Federation were analyzed. Methods of systematization and comparative analysis were applied.
Results. Modern concepts of three types of reactions are summarized. It is shown that type I allergy is an IgE-mediated process that necessarily includes a sensitization stage. Autoallergy is based on the loss of tolerance to own antigens with the implementation of damage by types II–IV hypersensitivity. Pseudo-allergy is characterized by the absence of an immunological phase; the MRGPRX2 receptor of mast cells plays a key role. A classification of allergens and a comparative table are presented.
Conclusion. Despite the external similarity of clinical manifestations, allergic, autoallergic and pseudo-allergic reactions have fundamentally different pathophysiological mechanisms, which dictates the need for their clear differentiation for choosing the right therapeutic tactics.

In recent decades, a steady increase in autoimmune and metabolic diseases has been observed, underscoring the critical need to investigate their fundamental mechanisms. The pathogenesis of these conditions is increasingly attributed to the syndrome of increased intestinal epithelial permeability ("leaky gut"), with the disruption of its barrier function playing a key role in the early diagnosis and prevention of chronic pathology. This study aims to substantiate the concept of increased epithelial permeability syndrome as a pathogenetic component of systemic inflammation based on an analysis of current scientific evidence. To achieve this objective, an analysis of domestic and international scientific publications was conducted, focusing on the mechanisms of systemic inflammation, intestinal barrier disruption, and the role of the microbiota, lipopolysaccharide, and pro-inflammatory cytokines in these processes. The findings substantiate a two-phase model of syndrome development, encompassing stages of barrier destabilization and immune chronification. Particular attention is given to the role of interorgan communication axes ("gut-liver," "gut-brain," "gut-skin," "gut-joints," "gut-metabolic system," and "gut-cardiovascular system") in the initiation and perpetuation of chronic inflammatory diseases. The study concludes that increased epithelial permeability syndrome constitutes a significant pathogenetic link in systemic inflammation and may be regarded as a universal mechanism underlying the development of a wide range of chronic pathologies.

In the modern world, the problem of irreversible blindness has not yet been eradicated. Primary open-angle glaucoma (POAG) remains one of the main causes. The efficacy of prostaglandin analogs and β-blockers has undoubtedly been proven; however, in some patients, monotherapy with these agents fails to achieve the required intraocular pressure (IOP) targets. Therefore, the search for drugs with novel mechanisms of action in this therapy is equally necessary. Rho-kinase inhibitors represent the first class of antihypertensive agents that directly target the trabecular outflow pathway of aqueous humor. Aim. To evaluate the clinical potential of Rho-kinase inhibitors in comparison with traditional antihypertensive therapy in the treatment of glaucoma. Materials and methods. This review utilized contemporary scientific literature from the PubMed and eLibrary databases. The methods include a comparative analysis of statistical data and reports from Russian and international organizations. Results. Rho-kinase inhibitors improve aqueous humor outflow, thereby reducing IOP. This effect is achieved through relaxation of trabecular meshwork cells and Schlemm's canal endothelium. Phase III clinical trials have demonstrated that netarsudil 0.02% is comparable in efficacy to timolol 0.5%, and in combination with prostaglandin analogs, it provides an additional IOP reduction of 3–5 mmHg due to synergistic effects on the uveoscleral and trabecular outflow pathways. The majority of patients experience no adverse effects; in rare cases, conjunctival hyperemia may occur. Conclusion. Rho-kinase inhibitors possess high clinical potential, allowing us to consider them as a more effective alternative in the treatment of glaucoma or as an adjunct to traditional antihypertensive therapy. Particular attention should be paid to cases with an inadequate response to first-line treatment.

 Problematic gambling behavior, including its extreme form — gambling addiction, is characterized by persistence over time. The staff of the Neuropharmacology Laboratory at the Federal State Budgetary Scientific Institution "Institute of Experimental Medicine" (Saint Petersburg) have developed a glutamatergic blocker IEM-1460 — a selective inhibitor of the open channel conformation of AMPA receptors. Its anti-addictive effect is presumed to be associated with the interaction between glutamate and dopamine systems. Aim. To study the effect of an antagonist of GluA1-containing AMPA receptors (IEM-1460) on manifestations of gambling behavior in rats and its relationship with dopamine system modulation. Materials and Methods. The study was conducted on 5 male Wistar rats at the S.V. Anichkov Department of Neuropharmacology. A surgical procedure was performed during which the scalp was removed to access the skull, followed by electrode implantation into the lateral hypothalamic nuclei. The experiment was conducted ten days later, after which the rats were trained — to receive a stimulus, they had to press a lever with their paw. The effect of IEM-1460 on impulsive behavior manifestation and dopamine release in the nucleus accumbens in response to electrical stimulation of the ventral tegmental area was investigated. Results. IEM-1460 at a dose of 1 mg/kg (intraperitoneally) significantly reduced impulsivity symptoms. During the experiments, enhanced dopamine release in the nucleus accumbens was recorded upon stimulation of the ventral tegmental area. Conclusion. Selective blockade of calcium-permeable GluA1-AMPA receptors by IEM-1460 effectively reduces behavioral manifestations of gambling addiction in rats, particularly impulsivity. The mechanism is associated with normalization of glutamatergic regulation of the dopamine system. The results confirm the promise of developing IEM-1460-based drugs for the treatment of gambling addiction.  

Epstein-Barr virus (EBV) and cytomegalovirus (CMV) often provoke tonsillitis and mononucleosis, contributing to bacterial complications. Despite the viral nature (90-95% of cases), antibiotics are prescribed unreasonably often, which increases resistance. Macrolides are the drugs of choice with penicillin restrictions. Objective: to study the resistance to macrolides of bacteria from the pharynx of patients with EBV/CMV-associated tonsillitis. Materials and methods: A retrospective analysis of pharyngeal crops in 14 patients (2017-2025, Luga MRB). Identification — MALDI-TOF MS; EBV/CMV —HLA (IgM) serology; sensitivity to macrolides (azithromycin, etc.) is a disco diffusion method (EUCAST). Results: Conditionally pathogenic bacteria were detected in all of them. Of the 4 gram—positive isolates analyzed (Staphylococcus aureus, Streptococcus agalactiae), 2 strains of S. aureus (14% of otolates) are resistant to all macrolides; S. agalactiae are sensitive. Conclusions: Colonization of the pharynx by macrolide-resistant S. aureus (14%) was revealed, which reduces the effectiveness of therapy for bacterial complications in EBV/CMV infections.     

Obstructive sleep apnea (OSA) in children occurs in 5–10% of children aged 2–12 years and leads to serious consequences. Existing screening methods (questionnaires, polysomnography, wearable devices) have limitations for home use in children. The aim of the work is to develop the "Snore Guardian" software complex for multimodal analysis of physiological data and questionnaires for OSA screening. Materials and methods. The Python-based program with Tkinter interface includes a questionnaire (10 questions on pediatric signs), audio upload (pause analysis, snoring spectrum), pulse oximetry (ODI3), BP/HR, and position. Data are integrated into a single table and processed by machine learning algorithms. Results. A prototype has been created that correctly detects apnea episodes from audio and saturation, forming a structured output. Conclusion. The program allows for unified data collection for pediatric OSA screening at home; further validation on a clinical sample is required.

In recent years, there has been an increase in the consumption of dietary supplements in many countries around the world, including Russia. Dietary supplements are particularly popular among young people focused on disease prevention and maintaining general well-being. At the same time, a significant portion of supplements are used without a doctor's prescription, under the influence of advertising and internet sources. When conducting sociological research, an important factor affecting the reliability of results is the survey format. In reactive surveys, respondents may give answers that correspond to socially approved attitudes, which is associated with the phenomenon of social desirability. The use of non-reactive techniques, particularly game-based or indirect question phrasing, can reduce this effect and elicit more spontaneous responses. Objective. To analyze the characteristics of dietary supplement use among young residents of St. Petersburg, assess the impact of the survey format (reactive and non-reactive) on the structure of respondents' answers, and compare them with the answers of respondents in the 46-60 age group. Materials and Methods. We developed two anonymous questionnaires, including more than 250 parameters, containing questions identical in meaning about the use of dietary supplements, the purposes of use, selection criteria, and the influence of medical recommendations on the decision to take dietary supplements. Based on the questionnaires, a survey was created using Google Forms (GF) (in the Russian Federation) and Uquiz (U) (outside the Russian Federation). Data analysis was performed using descriptive statistics methods in the Statistica program. Results. A total of 287 residents of St. Petersburg aged 18 to 65 were surveyed. Of the 287 respondents, 55 responded via GF and 234 via U. Among those who responded via GF, respondents aged 18-25 predominated, accounting for 34% (n=19); the second largest group was respondents aged 46-60 – 28% (n=16). The age of all those surveyed via Uquiz was significantly younger: 90% (n=210) were aged 18-25. These groups were selected for comparative analysis. Experience with dietary supplements was reported by 80% of young GF respondents (n=15) and 60% of U respondents (n=140), while in the 46-60 age group this figure was 75% (n=12). In the reactive GF survey, young respondents more often cited a doctor's recommendation (46%), whereas among the Uquiz youth, the independent decision to take dietary supplements dominated (47%). The most common purpose of taking dietary supplements in all groups was immune support: Google Forms youth - 23% (n=4), Uquiz youth - 33% (n=69), 46-60 age group - 26% (n=4). In all groups, the most common supplements were vitamin D - 26% (n=5) GF and 24% (n=50) U, omega-3 - 21% (n=4) and 17% (n=36) respectively, vitamin C - about 20% (n=48). Among the most frequently mentioned manufacturers were Solgar - 35% (n=7) among young GF respondents and 24% (n=50) in Uquiz, and Evalar - 20% (n=4) and 22% (n=46). In the reactive Google Forms survey, 81% (n=15) of young respondents rated dietary supplements positively or neutrally. In the non-reactive Uquiz format, the response structure was different: about 50% (n=105) of respondents demonstrated a skeptical attitude towards the effectiveness of dietary supplements. In the 46-60 age group, a positive attitude was noted in 72% (n=12) of cases, but the need for a doctor's consultation before taking supplements was more often emphasized. Conclusion. The majority of surveyed residents of St. Petersburg have experience using dietary supplements. The most frequently used supplements are those containing vitamin D, omega-3, and vitamin C, used primarily for immune support. Young respondents are more likely to take dietary supplements on their own initiative, whereas individuals aged 46-60 are more likely to follow doctor's recommendations. The obtained data confirm the influence of the social desirability phenomenon, which can distort survey results when questions are asked directly. 

Relevance. Arterial hypertension (AH) in children is a predictor of cardiovascular diseases in adults. However, its asymptomatic course and blood pressure (BP) variability complicate timely diagnosis, necessitating the search for new screening approaches considering modifiable risk factors.Objective. To assess the prevalence of elevated BP in schoolchildren and to study its relationship with anthropometric parameters (BMI, triponderal mass index – TMI), anxiety levels, and physical activity. Materials and methods. The study involved 231 schoolchildren aged 7–17 years (120 boys, 111 girls). Anthropometry, BP measurement, anxiety assessment (Lüscher test), and analysis of additional physical activity data were performed. BP was classified according to national guidelines.
Results. The prevalence of AH was 18.2% (boys – 25.0%, girls – 10.8%; p<0.05). A strong positive correlation was found between BMI/TMI categories and the frequency of AH (p<0.05). TMI demonstrated higher diagnostic accuracy in predicting AH compared to traditional BMI. AH was significantly more common among children engaged in physical activity (14.3% vs. 3.9%; p<0.05), as well as in those with high anxiety levels (39.4%; p<0.05). The maximum risk (47.8%) was recorded with the combination of high anxiety and physical exertion.Conclusion. The findings confirm a high prevalence of AH among schoolchildren. The use of TMI increases screening efficiency. The identified association of AH with physical activity and anxiety indicates the need for a comprehensive psychophysiological approach to health monitoring and consideration of the nature of physical exertion.

Bronchial asthma (BA) is one of the most common chronic diseases in children. Beyond classical respiratory symptoms, it exerts significant systemic effects, particularly on sleep quality and duration. The Levin questionnaire was used in the study to identify sleep disorders in the examined children. Insomnia was detected in 9 (17.3%) patients, while a borderline condition was observed in 24 (46.2%) surveyed patients. Postsomnic disorders were statistically significantly more frequent in children with severe BA, whereas intrasomnic disorders were noted exclusively in children with moderate-severe BA. Correlation analysis revealed statistically significant inverse relationships between the total Levine scale score and both patient age and duration of BA. Thus, as children grow older and the duration of the disease increases, a distinct decline in sleep quality is observed.

In the context of the global fight against cancer, the prevention of infections associated with oncogenic viruses is a particular priority. Human papillomavirus (HPV) is a group of extremely common viruses transmitted primarily through sexual contact. HPV causes the development of a number of benign (genital warts) and malignant oncological diseases, including cervical cancer, anal cancer, oropharyngeal cancer, and others. Vaccination against HPV is an effective measure for the prevention of these diseases; however, its success largely depends on the level of public awareness of the epidemiology, etiology of HPV, and available methods of prevention, such as a screening program and a timely preventive vaccination campaign. Objective. To assess the level of awareness of the population of Voronezh and the Voronezh region about the epidemiology, etiology, and prevention of diseases caused by HPV. Materials and methods. We analyzed the results of a survey of parents living in Voronezh and the Voronezh Region who sought advice on infectious disease vaccination for their children. Results. The findings indicate a lack of public awareness of HPV and its prevention measures. Conclusion. The study identified the need to develop and implement educational programs aimed at raising public awareness of HPV, preventing associated diseases, and expanding vaccination access.

Bronchial asthma is a common respiratory disease, which carries the risk of patient disability. A special group of patients consists of children with bronchial asthma against the background of connective tissue dysplasia, which can complicate the diagnosis and treatment of the disease. Objective: To determine the features of bronchial asthma against the background of connective tissue dysplasia. Materials and methods. The study was based on the medical histories of children treated in the pulmonology department of Voronezh Pediatric Clinical Hospital in 2024-2025. Of the total 1,872 patients, bronchial asthma was diagnosed in 1,133 cases. The case histories of 48 patients with bronchial asthma were selected for analysis. The analysis of medical history data was conducted using statistical techniques. Results. Connective tissue dysplasia in patients modifies the clinical presentation of bronchial asthma, contributing to an earlier onset and a prolonged duration of symptoms during exacerbations. Conclusion. Connective tissue dysplasia is a factor that aggravates the course of bronchial asthma, which requires a more careful approach to diagnosis and the development of individualized therapeutic programs for this category of patients.

Liver cirrhosis in children is a severe chronic disease with a high risk of progression and complications, which determines the need to study its etiological and clinical features. The aim of this study was to investigate the structure of causes, clinical manifestations, and diagnostic indicators of liver cirrhosis in children.A retrospective analysis of 70 medical records of patients who received inpatient treatment between 2021 and 2025 was conducted. Clinical symptoms, laboratory findings, and data from instrumental diagnostic methods, including liver FibroScan assessment, were evaluated.It was established that intrauterine infections, congenital anomalies, and hereditary metabolic disorders play a leading role in the development of liver cirrhosis. The disease is more frequently detected at an early age and is characterized by signs of cholestasis, portal hypertension, and impaired physical development. Laboratory changes reflect cytolysis syndrome, impaired synthetic liver function, and coagulopathy. A significant proportion of patients demonstrated advanced stages of liver fibrosis, indicating late diagnosis of the disease. The obtained data emphasize the need for early detection of chronic liver diseases and improvement of diagnostic approaches in pediatric practice.

Recently, there has been a significant increase in the incidence of primary arterial hypertension (AH) worldwide, driven by the rising number of overweight and obese children. Consequently, some patients already develop a stable form of AH during adolescence and exhibit signs of target organ damage. To identify the clinical features of labile and stable forms of AH, a retrospective analysis was conducted on 154 medical records of patients who underwent inpatient treatment in the Cardiology and Endocrinology departments of the Voronezh Regional Children's Clinical Hospital (VDKB) at the N.N. Burdenko Voronezh State Medical University (VSMU) between 2023 and 2025. According to the study, the stable form of arterial hypertension was more prevalent (64.3%), with boys predominating in both groups. Obesity was observed in 94.9% of children with labile AH and in 81.8% of patients with stable AH. Patients with stable AH had a relatively higher probability of presenting with hypercholesterolemia (29.1%). Increased fasting glucose levels were recorded in 40.4% of cases in the labile AH group and in 40% of cases in the stable AH group. The mean daily systolic blood pressure (SBP) values were comparable between patients with labile and stable forms of AH, although they were higher in males. The maximum SBP and diastolic blood pressure (DBP) were higher in boys from the stable AH group. These results highlight the need for comprehensive laboratory and instrumental testing in adolescents with arterial hypertension and confirm the leading role of obesity in elevating blood pressure in this population.

Relevance. In recent decades, rheumatological diseases have become a serious problem due to their high incidence in children. The aim of this study is to examine the nosological structure, clinical features, diagnostic stages, and treatment of patients with juvenile autoimmune diseases. Materials and Methods. We analyzed data from 36 pediatric outpatient records seen by a cardiologist-rheumatologist at a children's clinic in Voronezh in 2026. Based on this study, we identified the clinical features, diagnosis, and treatment of juvenile autoimmune diseases. The following research methods were used: complete blood count and urine analysis, blood biochemistry, rheumatological factors (test of antinuclear antibodies (ANA), Ig G antibodies to double-stranded DNA (Anti dsDNS Ig G), HLA B 27 histocompatibility gene, antistreptolysin-O (ASTLO), rheumatoid factor (RF), immunoglobulins Ig A, Ig M, components of the complement system (C3), creatine phosphokinase (CPK), lactate dehydrogenase (LDH), fecal calprotectin), coagulograms, electrocardiograms (ECG), echocardiography (Echo-CG), ultrasound examination (US) of adjacent joints. Among the nosological structure of the studied group of patients, seronegative juvenile chronic arthritis prevailed, which was most often characterized by damage to the knee and ankle joints. Conclusion. An analysis of the study group of children revealed no significant abnormalities in routine laboratory tests at the onset of rheumatic diseases. Seropositive juvenile chronic arthritis was more often characterized by prolonged febrile fever, high laboratory activity, an aggressive course, and difficulty in selecting therapy.

Currently, migraine ranks as the second leading cause of years lived with disability worldwide, predominantly affecting individuals of working age. For many years, specific treatment options were limited to triptans, which have significant drawbacks, including contraindications in patients with cardiovascular risks and reduced efficacy when administered late after attack onset. A major advance in understanding migraine pathogenesis was the discovery of the pivotal role of calcitonin gene-related peptide (CGRP). This finding led to the development of monoclonal antibodies; however, their use is limited by the need for injections and high costs. Gepants, which are small molecules that block CGRP receptors, have emerged as a promising alternative. These agents do not cause vasoconstriction and have proven effective both for acute treatment and preventive therapy. The aim. To review and summarize current evidence on the mechanism of action, efficacy, and safety of gepants based on recent clinical studies. Materials and methods. An analysis of international scientific literature available in the PubMed, Scopus, and Cochrane Library databases was performed. Results. The analysis confirmed that gepants selectively block CGRP receptors on trigeminal nerves without affecting coronary artery tone. In clinical trials, rimegepant (75 mg) was significantly more effective than placebo in achieving pain freedom two hours after dosing (21.3% vs. 10.9%). Ubrogepant (50 mg) maintained a favorable safety profile with intermittent use up to eight times per month. Adverse effects were generally mild, including nausea and dry mouth, and did not lead to treatment discontinuation. Atogepant, approved for migraine prevention, reduced mean monthly migraine days by 4.2 days compared to baseline in a 52-week study. Conclusions. Gepants offer an effective and safe alternative to triptans and monoclonal antibodies for migraine patients. Their oral administration and lack of vasoconstrictor effects broaden therapeutic options, particularly for individuals with concomitant cardiovascular conditions.

Unlike wound dressings, which were already used as early as 2500 BCE, specialized hemostatic agents appeared only a few decades ago. Ancient people used various substances to treat wounds, but only a few of them had a disinfecting effect. Most folk remedies added to dressings only caused harm, exacerbating suffering and prolonging wound healing time. The first hemostatics, which to some extent promoted blood clotting, were various medicinal herbs and decoctions based on them—for example, nettle, yarrow, and guelder rose bark. Many centuries ago, dry moss was commonly applied to wounds to stop bleeding. However, it should be noted that all these folk remedies were used empirically. There was no scientific basis, nor any understanding of the mechanism of hemostasis in the human body (the natural blood clotting process). The first scientific research in this area was conducted in the late 19th century, when platelets were discovered. Shortly afterward, the important role of calcium in the blood clotting process was demonstrated. In 1918, heparin—a substance that prevents hemostasis—was described in detail. In the early 20th century, warfarin and protein C were discovered; these are also anticoagulants. All these discoveries supported serious scientific research in the search for truly effective hemostatic agents. This was also considered after World War II, during which simple dressings and disinfectants still dominated field medicine. There were essentially no hemostatics that actually accelerated blood clotting. The first effective hemostatic agents appeared only in the late 1960s. This was made possible by the existing understanding of the hemostasis mechanism and knowledge of the three main anticoagulants. However, serious research that enabled a giant leap in the development of hemostatic drugs only began in the early 1990s in the United States. Modern surgery and combustiology still face the problem of stopping bleeding. Medicine imposes high demands on local hemostatic agents and barrier materials. An ideal preparation should not only stop bleeding effectively and quickly (including capillary, venous, and parenchymal bleeding) but also be biocompatible and, ideally, fully biodegradable—to eliminate the need for repeat surgery to remove it. In this context, polysaccharide derivatives capable of being resorbed in body tissues are of particular interest. Among the most promising compounds in this class are highly oxidized celluloses, known as oxycelluloses. Both individual compounds and materials based on them are widely used in medical practice. They combine the properties of a biocompatible polymer and a physiologically active substance, which ensures their effectiveness in stopping capillary, venous, and minor arterial bleeding. 

The relevance of this study stems from the need for a critical reappraisal of the phenomenon of tarantism ("St. Vitus' Dance"), common in southern Italy from the 14th to the 17th centuries. In an era of superstition and stigmatization of mental disorders, this condition, believed to be caused by a tarantula bite, served as a way to express suffering, masking social and psychological stress. The aim of this study is to critically analyze the phenomenon of tarantism from a historical and medical perspective. The study utilizes an analytical method examining historical and contemporary scientific literature, a comparative analysis of medieval descriptions of symptoms with modern toxicological data, and an analysis of the socioeconomic and cultural factors of southern Italy from the 14th to the 17th centuries. The results demonstrate that modern toxicological data completely refutes the connection between tarantula bites and the described mental disorders. It has been established that tarantism is a manifestation of conversion disorder, deeply rooted in the cultural context. The mass character and ritualized nature of the phenomenon are explained as a socially sanctioned mechanism for coping with stress through group ecstasy and social contagion. The conclusion is that tarantism should be viewed as a complex psychosocial phenomenon, demonstrating the powerful interaction of psyche, culture, and social circumstances. The tarantella ritual served as a socially acceptable way to express suffering in the absence of adequate medical care.

The active integration of digital technologies into the educational process and leisure activities of schoolchildren can lead to the formation of digital dependence, which negatively affects the psycho-emotional state and cognitive skills of children. The aim of this work was to establish the relationships between the degree of smartphone dependence, psychological state, and cognitive skills in schoolchildren. A total of 30 schoolchildren aged 11-14 years (15 boys, 15 girls) were tested. Validated test questionnaires were used: the Smartphone Addiction Scale (SAS), the Children's Depression Inventory (CDI), the Children's Manifest Anxiety Scale (CMAS), the Stroop test, as well as academic performance data, with subsequent frequency and correlation analysis. It was revealed that girls show a high correlation between dependence and depression (r=0.64; p<0.01), age and dependence (r=0.67; p<0.01), as well as a trend (r=0.31) towards an increase in the rigidity of cognitive control with age. In boys, the median values were higher and more homogeneous, with the difference in anxiety levels being statistically significant (p=0.036) and associated with an increase in the rigidity of cognitive control (r=0.37). In both groups, there was a positive correlation between depression and anxiety (r=0.62 and r=0.75). 80% of the subjects had negative values on the rigidity/flexibility of control index (ID). The obtained results indicate a link between digital dependence and the psycho-emotional state of schoolchildren.

Infants born with extremely low birth weight (less than 1000 g) (ELBW) constitute the group with the highest risk of neonatal morbidity and mortality. In Russia, as elsewhere, there is a trend toward increasing survival of these infants due to improvements in perinatal technologies. However, survival is inextricably linked to quality of life, which is largely determined by the effectiveness of nursing staff. The specific nature of caring for extremely premature infants requires nurses to possess specialized knowledge and skills that extend beyond the general principles of neonatology. Incorrect care can lead to serious consequences such as intraventricular hemorrhage, bronchopulmonary dysplasia, retinopathy, and psychomotor developmental disorders. Despite the abundance of clinical guidelines, a gap exists between theory and actual nursing practice, making it crucial to study and standardize approaches to caring for this category of patients. Objective. To study and systematize the key features of nursing care for extremely low birth weight newborns in the intensive care unit. Materials and methods. An analysis of scientific and methodological literature on neonatology and nursing was conducted, as well as a review of current clinical guidelines and orders of the Russian Ministry of Health regulating the care of children with extreme low birth weight. A participant observation method was used to study the work of nursing personnel in the intensive care unit for newborns (based at the Voronezh Regional Clinical Hospital No. 1, Voronezh) for 2025-2026. A survey of 10 nurses was conducted to identify the difficulties and specifics of their work with this group of patients. Results. The conducted research made it possible to identify several key aspects related to nursing care for extremely low birth weight newborns in the intensive care unit. First, nurses must strictly follow established protocols and recommendations, which include regular monitoring of newborns, assessing their vital signs, and promptly responding to changes. Second, medical staff must possess specialized knowledge and skills for working with newborns, including the ability to perform resuscitation, provide adequate nutrition, and provide skin care. Furthermore, caring for ELBW newborns requires nurses to be highly emotionally resilient and adapt quickly under stress. This also includes working with parents, who may experience fear and anxiety. The survey also revealed that the main challenges faced by nurses include high staff workload, the need for ongoing training to maintain knowledge, and timely professional development. Effective care for ELBW newborns requires collaboration not only between nurses but also with doctors and other medical personnel, which facilitates a more professional approach to care. Therefore, a team approach and respect for chain of command are essential. Thus, nursing care for newborns with ELBW has a number of specific features, which include not only the performance of nursing duties, but also the constant updating of knowledge, the ability to work in a team, communicate with parents, and prevent emotional burnout.

The proper functioning of the complex human body is directly linked to an individual's lifestyle, aspirations, motivations, and self-organization. Modern students face rigorous pedagogical demands, requiring them to engage in intensive study of academic material. Excessive perseverance and diligence in students can negatively impact their health and cause various functional and/or organic changes in any system of the body. Therefore, knowledge and activities that naturally enhance performance and promote the maintenance and improvement of health are highly relevant. Objective: To present activities that improve the performance of student youth. Materials and methods: Printed and electronic resources, online testing results. Methods: analytical, comparative, statistical, and descriptive. Results. During the intense period of acquiring professional knowledge and skills, it's important to strive to implement comprehensive healthy lifestyle measures, avoid unhealthy habits, and make greater use of the diverse wellness resources available at the educational institution and/or in the city. Furthermore, a good command of a foreign language helps students navigate information resources more effectively and potentially reduces labor costs. Conclusion. To successfully study at a university in today's urban environment, young people require stable performance based on sustainable health, which must be consciously protected and actively strengthened.

By 2030, the proportion of Russian citizens over 65 will exceed 20 percent, making population aging one of the key demographic challenges of our time [1]. Against the backdrop of limited inpatient hospital beds and growing demand for support in familiar environments, family care is emerging as a socially and economically effective model. This model reduces the burden on the inpatient care system and helps maintain the quality of life of the elderly. Nurses, as specialists who directly interact with patients and their families, play a central role in preparing relatives for care. This approach directly aligns with the goals of the national project "Long and Active Life," aimed at ensuring active and healthy longevity

The study is devoted to the psychological aspects of nursing students’ work with palliative patients. The relevance of the research is обусловлена population aging and the increasing number of patients with incurable diseases who require palliative care, the primary goal of which is to improve quality of life and ensure dignified care. The aim of the study was to identify the characteristics of nursing students’ psychological reactions when working with palliative patients and to determine directions for improving their psychological training. The theoretical foundations of palliative care, the specifics of interaction with patients and their relatives, and the risks of professional burnout were examined. The practical part of the study was based on a questionnaire survey of 30 nursing students who completed clinical practice at Voronezh Regional Clinical Hospital No. 1 and Voronezh City Emergency Hospital No. 1. The results demonstrated a moderate level of emotional exhaustion (3.76 points), which was higher among students with practical experience. Depersonalization was identified at a moderate level (3.3 points) and is considered a protective mechanism. At the same time, professional motivation remained high (4.0 points), and working with palliative patients strengthened the sense of professional significance. Communication proved to be the most challenging area (4.02 points): students reported difficulties discussing death, choosing supportive words, and interacting with patients’ relatives. The greatest emotional strain was associated with the need for recovery after a patient’s death. Recommendations were developed to improve training, including the introduction of difficult communication training, simulation of clinical situations, and the development of self-regulation and supervision skills. Psychological training is a key condition for developing professional resilience and ensuring high-quality palliative care.

This paper examines adolescent awareness of the rules and importance of personal hygiene during a period of active physiological development. This topic is relevant because adolescence is accompanied by hormonal changes requiring specific body care, as well as the high social activity of young people, which increases the risk of infectious diseases.We conducted a study on adolescent awareness of personal hygiene. For this purpose, we developed an original questionnaire containing 12 questions on personal hygiene and the consequences of poor hygiene. Fifty-eight ninth-grade students, aged 15-16, participated in the survey.Analysis of the responses revealed that approximately 60% of respondents neglect regular showering and brushing their teeth, and approximately 50% do not associate poor hygiene with the risk of contracting hepatitis A. These results support the hypothesis that adolescents' knowledge is superficial and requires improvement through educational programs. The practical significance of this work lies in the development of recommendations for teachers and parents on how to increase students' motivation to comply with sanitary regulations. These proposals are aimed at preserving the health of the younger generation and reducing the incidence of illness in organized groups.

The prospects of using K‑ion-selective field-effect transistors equipped with photopolymerizable polyurethane membranes for monitoring the electrolyte content in parenteral nutrition solutions and biological fluids (including blood plasma) of patients undergoing long-term parenteral therapy are considered. The technology opens up new possibilities for the diagnosis and control of therapy in clinical medicine. Goal. To analyze and substantiate the feasibility of an innovative approach to monitoring the patient's electrolyte status and parenteral nutrition solutions through the use of K‑ion selective field-effect transistors with photopolymerizable polyurethane membranes. Materials and methods. Analysis of literature data on parenteral nutrition of patients and the use of ion-selective field-effect transistors in medical practice. Results. The advantages of ion-selective field-effect transistors with polyurethane photopolymerizable membranes will make it possible to provide a personalized approach to prescribing parenteral nutrition in patients deprived of the opportunity to receive enteral nutrition. Conclusions. The use of potassium-selective field-effect transistors with photopolymerizable polyurethane membranes will make it possible to control the composition of potassium both in nutrition solutions and in whole blood and plasma of patients, which will avoid serious complications in patients.

Relevance. Pneumonias are a group of acute infectious and inflammatory processes with varying etiology, pathogenesis, pathological changes, and clinical presentation, primarily affecting the alveoli.Objective: To study the risk factors for the development and clinical features of community-acquired pneumonia (CAP), as well as to explore the specifics of nursing care for this disease.Methods. A survey of patients with CAP was conducted using the "Questionnaire for the Study of Risk Factors for the Development and Clinical Features of Community-Acquired Pneumonia," developed by the authors themselves. Forty-five patients aged 19 to 77 years participated in the study, including 25 women (55.6%) and 20 men (44.4%). The average age of respondents was 48 ± 29 years.Results. The study revealed that the majority of patients with community-acquired pneumonia (60.0%) had hypothermia before the onset of the disease, and more than half of patients (64.4%) reported contact with patients with acute respiratory disease before the development of the clinical picture of pneumonia.Findings. The most common complaints of patients with CAP were weakness, sweating, fever, cough with sputum, and shortness of breath. More than half of the patients with CAP (79.9%) highly rated the quality of care provided to them by nurses.

The demographic crisis is a pressing issue in modern society, one of the reasons for which is the "unpreparedness" of expectant parents to take responsibility for a child. This is due to a lack of understanding of how to care for a newborn and the fear of harming them, which is linked to a lack of education in this area and the numerous "myths" that many believe. Nowadays, many people planning to become parents prepare for it well in advance. In addition to quitting bad habits, they attend lectures, courses, and much more, but after the baby is born, they realize they still can't handle basic medical issues. This is why maternity hospitals and perinatal centers employ nurses. After the birth of their first child, parents begin to learn new skills, such as feeding, washing and bathing, changing personal hygiene products, putting the baby to bed, etc., which is a very serious process. From the first day a baby is born, in addition to its mother, a nurse is present. This nurse is the mother's second set of hands, teaching the woman how to care for her child and helping her adjust to her new status. The nurse not only helps, but also educates and supports the mother and cares for her mental and physical well-being, helping her transition to a new level of life more easily and confidently. Objective. To identify and analyze the main areas of nursing care for young parents, evaluate their effectiveness from the parents' perspective, and determine the key factors influencing satisfaction with nursing care. Materials and Methods. The study included a survey of parents (n=30) at a children's clinic, as well as a secondary analysis of the results of surveys of nurses (n=72) conducted as part of the Forums of Pediatric Nurses. Results. Key areas of nursing care most in demand by young families were identified: educational support for newborn care, breastfeeding assistance, and psychological support. It has been established that the effectiveness of nursing care is determined not only by professional competence but also by developed communication skills, empathy, and accessibility of information. The concept of a nurse as a key link between the family and the healthcare system, facilitating the development of confident parenting, is substantiated. Conclusion. The study confirms the key role of a nurse in supporting young parents. Empirical data demonstrate that parents highly value nursing recommendations, especially in the first month of a child's life, and have high expectations for both the professional competence and personal qualities of a nurse.